Moving beyond tight glucose control to safe effective glucose control
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* Corresponding author: Jean-Charles Preiser jkrinsley@stamhealth.org
1 Division of Critical Care, Stamford Hospital, 190 West Broad Street, Stamford, CT 06902, USA
2 Department of General Intensive Care, University Hospital Centre of Liege, Domaine Universitaire de Liège, 4000 Liege, Belgium
Critical Care 2008, 12:149 doi:10.1186/cc6889
Published: 16 May 2008Abstract
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.