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Intensive insulin therapy — designed to normalize blood glucose levels — is advocated increasingly for hyperglycemic patients in intensive care units. Nevertheless, convincing evidence of benefit comes mainly from only one trial conducted primarily in critically ill patients who had just undergone cardiac surgery (Journal Watch Nov 16 2001). In this new study, German researchers randomized about 500 ICU patients with severe sepsis to intensive insulin therapy (initiated when glucose levels exceeded 110 mg/dL; target, 80–110 mg/dL) or to conventional insulin therapy (initiated when glucose levels exceeded 200 mg/dL; target, 180–200 mg/dL). To compare colloid and crystalloid therapy, patients were also randomized to receive hydroxyethyl starc…