Tight Glucose Control Does Not Affect Length of Time Needed in ICU

THURSDAY, Sept. 28, 2023 (HealthDay News) -- For critically ill patients in the intensive care unit (ICU), tight glucose control does not affect the length of time that ICU care is needed, according to a study published in the Sept. 28 issue of the New England Journal of Medicine.

Jan Gunst, M.D., Ph.D., from the University Hospitals of KU Leuven in Belgium, and colleagues randomly assigned patients to liberal glucose control (insulin initiated only when the blood-glucose level was >215 mg/dL) or tight glucose control (blood-glucose level targeted with the use of the LOGIC-Insulin algorithm at 80 to 110 mg/dL) on admission to the ICU (4,622 and 4,608, respectively). The primary outcome was the length of time that ICU care was needed.

The researchers found that the median morning blood-glucose level was 140 and 107 mg/dL with liberal and tight glucose control, respectively. Severe hypoglycemia occurred in 0.7 and 1.0 percent of patients in the liberal- and tight-control groups, respectively. The two groups had similar length of time that ICU care was needed (hazard ratio for earlier discharge alive with tight glucose control, 1.00; 95 percent confidence interval, 0.96 to 1.04; P = 0.94). Similar mortality was seen at 90 days (10.1 and 10.5 percent with liberal and tight glucose control, respectively).

"Further lowering of blood-glucose levels into the normal fasting range, guided by a computer algorithm, avoided iatrogenic hypoglycemia without affecting the length of time that ICU care was needed or mortality," the authors write.

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