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Hyperglycemia is estimated to occur in as many as 40% of hospitalized medical and surgical patients. Given the association of hyperglycemia with morbidity and mortality, many studies have been conducted to evaluate whether intensive insulin therapy (IIT), aimed at strict glycemic control, improves outcomes. Although an early study suggested a benefit from IIT in critically ill surgical patients (JW Gen Med Nov 16 2001), many subsequent trials, including one involving critically ill medical and surgical patients (JW Gen Med Mar 24 2009), have shown no benefit.
In a systematic review of randomized controlled trials for the American College of Physicians (ACP), researchers evaluated clinical outcomes of IIT aimed at achieving tight glucose cont…