Abstract
Clinical trials over time have used a variety of approaches for both measuring tight glycemic control and reporting results. The review by Finfer and colleagues in this issue of Critical Care is a step toward consensus within the research community to standardize the way blood glucose is measured and reported in clinical trials. The authors propose using specific measures of central tendency and dispersion for reporting glucose, advocate the use of blood gas analyzers and elimination of point-of-care glucose monitors in the intensive care unit, and comment on performance of continuous glucose monitors. As we await the release of updated rules from the International Standards Organization and process the new rules from the Clinical Laboratory and Standards Institute to regulate glucose monitoring, these recommendations should trigger many more conversations within the field as we strive for uniformity. However, we need to be cautious in prematurely proposing and adopting standards of care that fail to account for newer technology and data in this rapidly growing area of research.
Highlights
Clinical trials over time have used a variety of approaches for both measuring tight glycemic control and reporting results
*Correspondence: michael.agus@childrens.harvard.edu 2Division of Medicine Critical Care, Department of Medicine, Boston Children’s Hospital; Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA Full list of author information is available at the end of the article
The group discussed and made recommendations in five areas: (a) measurement of intermittent blood glucose (BG) and characterization of those measurements, (b) performance standards for BG measurement devices, (c) use of continuous glucose monitoring (CGM), (d) assessment of CGM, and (e) performance of CGM. They cited much of the relevant published literature over the last several years, their task was daunting, with new and improved BG measurement technology just recently brought to the inpatient setting [2]
Summary
Clinical trials over time have used a variety of approaches for both measuring tight glycemic control and reporting results. Whether to perform tight glycemic control (TGC) in the adult intensive care unit (ICU) continues to be debated among intensivists and endocrinologists worldwide, how to report and assess TGC took a constructive step forward with the publication of the consensus recommendations in this issue of Critical Care [1]. The authors, some of whom are the principal investigators from many of the major adult TGC trials in
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