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01-08-2008 | Letter

Is "safe effective glucose control" effective and safe?

Authors: Marcus J Schultz, Greet Vanden Berghe

Published in: Critical Care | Issue 4/2008

Excerpt

Since tight glucose control (TGC) inevitably comes with a risk of hypoglycemia, Krinsley and Preiser [1] suggest the use of a stepwise approach to glucose control, which they call "safe, effective glucose control" (SEGC), and that targets an intermediate blood glucose level (BGL). SEGC is intended to decrease the rate of hyperglycemia while reducing the adverse effects of severe hypoglycemia. …

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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

Finney SJ, Zekveld C, Elia A, Evans TW: Glucose control and mortality in critically ill patients. JAMA 2003, 290: 2041-2047. 10.1001/jama.290.15.2041CrossRefPubMed

Vriesendorp TM, DeVries JH, van Santen S, Moeniralam HS, de Jonge E, Roos YB, Schultz MJ, Rosendaal FR, Hoekstra JB: Evaluation of short-term consequences of hypoglycemia in an intensive care unit. Crit Care Med 2006, 34: 2714-2718. 10.1097/01.CCM.0000241155.36689.91CrossRefPubMed

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Merz TM, Finfer S: Pro/con debate: Is intensive insulin therapy targeting tight blood glucose control of benefit in critically ill patients? Crit Care 2008, 12: 212. 10.1186/cc6837PubMedCentralCrossRefPubMed

Krinsley JS, Grover A: Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med 2007, 35: 2262-2267.CrossRefPubMed

Vespa P, Boonyaputthikul R, McArthur DL, Miller C, Etchepare M, Bergsneider M, Glenn T, Martin N, Hovda D: Intensive insulin therapy reduces microdialysis glucose values without altering glucose utilization or improving the lactate/pyruvate ratio after traumatic brain injury. Crit Care Med 2006, 34: 850-856. 10.1097/01.CCM.0000201875.12245.6FCrossRefPubMed

Title: Is "safe effective glucose control" effective and safe?
Authors: Marcus J Schultz
Greet Vanden Berghe
Publication date: 01-08-2008
Publisher: BioMed Central
Published in: Critical Care / Issue 4/2008
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc6960

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