Glucose Control in Critically Ill Patients

Abstract This chapter examines the findings of the NICE-SUGAR trial, which evaluated the effects of intensive glucose control in critically ill patients. The trial compared intensive glucose management (81 to 108 mg/dL) with conventional control (144 to 180 mg/dL) in medical and surgical intensive care unit (ICU) patients, focusing on 90-day mortality as the primary outcome. The results showed that intensive glucose control increased mortality and significantly raises the risk of hypoglycemia, with no clear benefits in ICU or hospital stay duration. These outcomes challenge previous recommendations for stricter glucose control and suggest a more moderate approach. Finally, glycemic targets of 140 to 180 mg/dL are recommended for critically ill patients to balance potential benefits and risks.