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At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
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Critical Care
Published in: Critical Care 5/2008

01-10-2008 | Letter

Evidence-lost to tight glycemic control?

Authors: Marcus J Schultz, Peter E Spronk, Ameen Abu-Hanna, Bekele Afessa, Ognjen Gajic

Published in: Critical Care | Issue 5/2008

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Excerpt

In recent years, the field of intensive care medicine has had the benefit of learning from two randomized controlled trials that tight glycemic control (TGC) is beneficial to critically ill patients [1, 2]. No benefit was found by two other clinical trials, however, hampering implementation of TGC in daily practice [3, 4]. The question arises of whether the intensive care community interprets the results of these later trials in the correct way. What are the alternative explanations for why two trials do show beneficial effects while two other trials do not, apart from the possibility that TGC may indeed not benefit critically ill patients? …
Literature
1.
Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R: Intensive insulin therapy in the critically ill patients. N Engl J Med 2001, 345: 1359-1367. 10.1056/NEJMoa011300CrossRefPubMed
2.
Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R: Intensive insulin therapy in the medical ICU. N Engl J Med 2006, 354: 449-461. 10.1056/NEJMoa052521CrossRefPubMed
3.
Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, Olthoff D, Jaschinski U, John S, Rossaint R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhart K: Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008, 358: 125-139. 10.1056/NEJMoa070716CrossRefPubMed
4.
De la Rosa GD, Donado JH, Restrepo AH, Quintero AM, Gonzalez LG, Saldarriaga NE, Bedoya MT, Toro JM, Velasquez JB, Valencia JC, Arango CM, Aleman PH, Vasquez EM, Chavarriaga JC, Yepes A, Pulido W, Cadavid CA: Strict glycemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care 2008, 12: R120. 10.1186/cc7017PubMedCentralCrossRef
Metadata
Title
Evidence-lost to tight glycemic control?
Authors
Marcus J Schultz
Peter E Spronk
Ameen Abu-Hanna
Bekele Afessa
Ognjen Gajic
Publication date
01-10-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7022

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