title: Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.
abstract: The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting.
authors.forename: Simon
authors.initials: S
authors.lastname: Finfer
authors.forename: Jan
authors.initials: J
authors.lastname: Wernerman
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Preiser
authors.forename: Tony
authors.initials: T
authors.lastname: Cass
authors.forename: Thomas
authors.initials: T
authors.lastname: Desaive
authors.forename: Roman
authors.initials: R
authors.lastname: Hovorka
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Joseph
authors.forename: Mikhail
authors.initials: M
authors.lastname: Kosiborod
authors.forename: James
authors.initials: J
authors.lastname: Krinsley
authors.forename: Iain
authors.initials: I
authors.lastname: Mackenzie
authors.forename: Dieter
authors.initials: D
authors.lastname: Mesotten
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Scott
authors.forename: Robbert
authors.initials: R
authors.lastname: Slingerland
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
authors.forename: Tom
authors.initials: T
authors.lastname: Van Herpe
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards*; D016638:Critical Illness / Q000628:therapy*; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D064887:Observational Studies as Topic / Q000379:methods
chemical_list: D001786:Blood Glucose