Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

This multicenter, randomized controlled trial investigated the effects of tight glucose control (target: 80–110 mg/dL) versus liberal glucose control (insulin initiated at >215 mg/dL) in 9230 critically ill ICU patients who did not receive early parenteral nutrition. The primary outcome was the length of ICU stay, with 90-day mortality as a safety endpoint. Results showed no significant difference in ICU stay (HR 1.00, 95% CI 0.96–1.04) or mortality (10.1% vs. 10.5%, P=0.51) between groups. Tight control reduced severe acute kidney injury (7.2% vs. 8.6%) and cholestatic liver dysfunction but did not impact infections or other secondary outcomes. The study concluded that tight glucose control, guided by a computer algorithm to minimize hypoglycemia, offered no significant clinical benefit in this population.

This multicenter, randomized controlled trial investigated the effects of tight glucose control (target: 80–110 mg/dL) versus liberal glucose control (insulin initiated at >215 mg/dL) in 9230 critically ill ICU patients who did not receive early parenteral nutrition. The primary outcome was the length of ICU stay, with 90-day mortality as a safety endpoint. Results showed no significant difference in ICU stay (HR 1.00, 95% CI 0.96–1.04) or mortality (10.1% vs. 10.5%, P=0.51) between groups. Tight control reduced severe acute kidney injury (7.2% vs. 8.6%) and cholestatic liver dysfunction but did not impact infections or other secondary outcomes. The study concluded that tight glucose control, guided by a computer algorithm to minimize hypoglycemia, offered no significant clinical benefit in this population.