Abstract
The results of the NICE-SUGAR (Normoglycaemia in Intensive Care Evaluation Survival Using Glucose Algorithm Regulation) trial were released last March. The primary outcome variable, 90-day mortality, was actually increased in patients randomly assigned to intensive insulin therapy, as compared with an intermediate target range for blood glucose. These findings, reflecting data collected in a set of more than 6,000 patients, clearly refute the external validity of tight glucose control. Future research will probably focus on several questions raised by the divergent results reported from investigations in the field of glucose control in the critically ill.
Highlights
On Tuesday, 24 March 2009 at 10:05 hours, the Erasmus Room of the Exhibition and Congress Centre of Brussels was overcrowded
Professor Simon Finfer, from the Royal North Shore Hospital of Sydney, Australia was about to release the results of the NICESUGAR (Normoglycaemia in Intensive Care Evaluation Survival Using Glucose Algorithm Regulation) trial, the largest clinical study conducted in critical care medicine to date
NICE-SUGAR was designed to test whether tight glucose control by intensive insulin therapy (TGCIIT; n = 3,010 evaluable patients) increases 90-day survival as compared with less strict glucose control (n = 3,012 evaluable patients)
Summary
On Tuesday, 24 March 2009 at 10:05 hours, the Erasmus Room of the Exhibition and Congress Centre of Brussels was overcrowded. NICE-SUGAR was designed to test whether tight glucose control by intensive insulin therapy (TGCIIT; n = 3,010 evaluable patients) increases 90-day survival as compared with less strict glucose control (n = 3,012 evaluable patients). Criticisms of each of the individual studies were raised, including inadequate statistical power and the use of various degrees of glucose control, all lower in the subsequent trials [3,4,5,6,7] than in the initial Leuven I study [2].
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