Treatment for hyperglycemia in the intensive care unit: a 'bittersweet' message

摘要

Background: Hyperglycemia, and insulin resistance are common in severe illness and are associated with a worse outcome. In 2001, a randomized, single-centre, prospective unblinded trial of surgical patients compared intensive-glycemic control (serum glucose 4.4-6.1 mmol-L~1) with more liberal glucose management. Significant decreases in mortality and morbidity were observed in the intensively treated group. In addition, a pronounced mortality benefit was demonstrated for patients who required intensive care unit (ICU) therapy for three or more days. It was unresolved as to whether or not these benefits may apply to medical ICU patients. This study was undertaken to address these issues.