Intensive insulin treatment reduced mortality and morbidity in critically ill patients
QUESTION: In patients who are critically ill, does normalisation of blood glucose concentrations with intensive insulin treatment reduce mortality and morbidity?
Design
Randomised (allocation concealed), blinded (patients, outcome assessors), controlled trial {with mean follow up of 23 days}*.
Setting
Surgical intensive care unit (ICU) at the university hospital in Leuven, Belgium.
Patients
1548 patients (mean age 63 y, 71% men) admitted to the ICU who were receiving mechanical ventilation. Patients were excluded if they were participating in other trials, were moribund, or had “do not resuscitate” orders. Follow up was 100%.
Intervention
Patients were assigned to receive intensive (n=765) or conventional (n=783) insulin treatment. Intensive treatment was insulin infusion that was started if the blood glucose concentration was > 6.1 mmol/l, and was adjusted to maintain a blood glucose concentration of 4.4–6.1 mmol/l (maximum insulin dose 50 IU/h). Conventional treatment was continuous insulin infusion …
