Moving beyond tight glucose control to safe effective glucose control

doi:10.1186/cc6889

Critical Care
Volume 12
Issue 3

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Commentary

Moving beyond tight glucose control to safe effective glucose control

James S Krinsley¹ and Jean-Charles Preiser²

¹Division of Critical Care, Stamford Hospital, 190 West Broad Street, Stamford, CT 06902, USA

²Department of General Intensive Care, University Hospital Centre of Liege, Domaine Universitaire de Liège, 4000 Liege, Belgium

author email corresponding author email

Critical Care 2008, 12:149doi:10.1186/cc6889


Published:	16 May 2008

See related letter by Schultz and Van den Berghe, http://ccforum.com/content/12/4/424

Abstract

The impressive benefits related to the use of tight glucose control by intensive insulin therapy have not been reproduced until now in multicenter large-scale prospective randomized trials. Although the reasons for these failures are not entirely clear, we suggest the use of a stepwise approach – Safe, Effective Glucose Control – that will essentially target an intermediate blood glucose level. As compared with genuine tight glucose control, Safe, Effective Glucose Control – already used in many intensive care units worldwide – is intended to decrease the rate of hypoglycemia and the workload, while reducing the adverse effects of severe hyperglycemia.