NDLI: Is reducing variability of blood glucose the real but hidden target of intensive insulin therapy?

Content Provider	Springer Nature : BioMed Central
Author	Egi, Moritoki Bellomo, Rinaldo Reade, Michael C
Abstract	Since the first report that intensive insulin therapy reduced mortality in selected surgical critically ill patients, lowering of blood glucose levels has been recommended as a means of improving patient outcomes. In this initial Leuven trial, blood glucose control by protocol using insulin was applied to 98.7% of patients in the intensive group but to only 39.2% (P < 0.0001) of patients in the control group. If appropriately applied, such protocols should decrease both the mean blood glucose concentration and its variability (variation of blood glucose concentration). Thus, it is logically possible that the benefit of intensive insulin therapy in the first Leuven trial was due to a decrease in mean glucose levels, a decrease in their variability, or both. Several recent studies have confirmed significant associations between variability of blood glucose levels and patient outcomes. Decreasing the variability of blood glucose levels might be an important dimension of glucose management, a possible mechanism by which an intensive insulin protocol exerts its putative beneficial effects, and an important goal of glucose management in the intensive care unit. Clinicians need to be aware of this controversy when considering the application of intensive insulin therapy and interpreting future trials.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc7755.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc7755
Journal	Critical Care
Issue Number	2
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2009-04-06
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Blood Glucose Level Blood Glucose Concentration Intensive Insulin Therapy Glycemic Variability Target Blood Glucose
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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