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In 2001, in a widely publicized trial from Leuven, Belgium, researchers demonstrated lower 90-day mortality with tight glycemic control (i.e., glucose levels, 80–110 mg/dL) in surgical intensive care unit (ICU) patients (NEJM JW Gen Med Dec 15 2001 and N Engl J Med 2001; 345:1359). This result led to a strong push from critical care organizations for early adoption of this practice in both surgical and medical ICUs. However, the Leuven researchers were subsequently unable to duplicate their findings in their own medical ICU (NEJM JW Gen Med Mar 1 2006 and N Engl J Med 2006; 354:449). Then, in 2009, a larger, multicenter study of medical and surgical ICU patients (NICE-SUGAR) demonstrated higher 90-day mortality and excess hypoglycemia (bloo…