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Prior studies of the effects of intensive glucose control in critically ill patients have yielded conflicting results. Now, in a multicenter trial (NICE-SUGAR), investigators randomized more than 6000 critically ill patients (63% medical; 37% surgical) to either intensive glucose control (target glucose level, 81–108 mg/dL) or conventional glucose control (target glucose level, 144–180 mg/dL). Control of blood glucose was achieved with intravenous insulin infusions. Participants were randomized within 24 hours after admission to intensive care units and were expected to require ICU treatment for 3 or more consecutive days.
The primary endpoint — death by 90 days after randomization — occurred significantly more often in the intensive-control…