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In a randomized trial published in 2001, Belgian researchers demonstrated that intensive insulin therapy lowered mortality among hyperglycemic surgical intensive care unit patients, most of whom had undergone cardiac surgery (N Engl J Med 2001; 345:1359). Now these researchers have conducted a similar randomized trial in their medical ICU.
Twelve hundred patients with anticipated ICU stays ≥3 days received either “conventional” insulin treatment (continuous infusion started when glucose exceeds 215 mg/dL and adjusted to maintain blood glucose at 180–200 mg/dL) or intensive insulin treatment (infusion started when glucose exceeds 110 mg/dL and adjusted to maintain glucose at 80–110 mg/dL). About 17% had known diabetes.
The primary endpoint, in…