Intensive insulin therapy in the ICU: is it now time to jump off the bandwagon?
Following the publication of the Leuven Intensive Insulin Therapy (IIT) study in 2001, tight glycemic control has become regarded as the standard of care in intensive care units throughout the world. The Leuven IIT study, was however, an unblinded, single center study with unique patient and institutional characteristics that may not extrapolate to practice elsewhere in the world. Indeed, recent randomized controlled studies have been unable to demonstrate any benefit from tight glucemic control. We suggest that the widespread adoption of tight glycemic control be abandoned at this time.
Marik
Paul E
PE
Pulmonary and Critical Care, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, United States. paul.marik@jefferson.edu
Varon
Joseph
J
D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003422:Critical Care / Q000639:trends*; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007362:Intensive Care Units
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin