Consider The Evidence: Med/Peds Journal Roundup

March 25, 2009

Nail in the coffin for intensive glucose control?

Filed under: Uncategorized — medblog @ 7:17 pm

NEJM 3/26/09 – The NICE-SUGAR investigators published the latest of several trials that show no benefit to intensive glucose control (see meta-analysis). In fact, this study shows increased mortality from tight gylcemic control in the ICU.

This appears to be a well done study – over 6,000 subjects, multicenter, both medical and surgical patients, 90-day follow up. Withdrawals were slightly higher in the treatment arm (10 vs 7 percent) but intent-to-treat analysis was used. Insulin use was non-blinded.

So should the intensive glucose control protocol be shelved next to blood-letting and COX-2 inhibitors?

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