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There is little evidence that tight control of blood glucose improves outcomes among hospitalized patients, but this issue has not been addressed in large trials. Therefore, Belgian investigators randomized 1548 patients in a surgical intensive care unit to either intensive treatment (insulin infusion started if blood glucose exceeded 110 mg/dL; goal, 80–110 mg/dL) or conventional treatment (insulin infusion started if blood glucose exceeded 215 mg/dL; goal, 180–200 mg/dL). Sixty-three percent of patients were admitted to the ICU after cardiac surgery, and 13 percent had diabetes.
During patients' ICU stays, mean morning glucose levels were 103 mg/dL and 153 mg/dL in the intensively and conventionally treated groups, respectively. Death rate…