Featured Research

from universities, journals, and other organizations

NICE SUGAR: Intensive Insulin Therapy Risks

Date:
March 24, 2009
Source:
Canadian Medical Association Journal
Summary:
Intensive insulin therapy significantly increases the risk of hypoglycemia in critically ill patients, according to a new study.

Intensive insulin therapy significantly increases the risk of hypoglycemia in critically ill patients, according to a new study in Canadian Medical Association Journal (CMAJ).

Intensive insulin therapy is used in many intensive care units around the world as a means to tightly regulate blood sugar. Although labour intensive, it has been recommended as a standard of care for critically ill patients by many organizations including the American Diabetes Association and the American Association of Clinical Endocrinologists.

A randomized trial in 2001 reported that intensive insulin therapy significantly reduced hospital mortality, although subsequent trials have reported inconsistent effects on mortality and higher rates of severe hypoglycemia.

The CMAJ study includes data from 26 trials, including the NICE-SUGAR Study on intensive insulin therapy, an international, multicentre randomized trial that is the largest intensive insulin therapy trial to date. The NICE-SUGAR study is published online in the New England Journal of Medicine March 24, 2009 and March 26 for the print edition.

"By including the largest trial on intensive insulin therapy published to date, we provide the most current and precise estimate of the effect of intensive insulin therapy on vital status and hypoglycemia in the ICU setting," write Dr. Donald Griesdale, anesthesiologist and critical care physician at Vancouver General Hospital and clinical instructor at the University of British Columbia, and coauthors.

The CMAJ study looked at 26 trials involving 13 567 patients. There was a 6-fold increased risk of hypoglycemia compared to the control treatment.

The study was conducted by researchers from the University of British Columbia and Vancouver General Hospital, Vancouver, BC; Harvard School of Public Health, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston, Mass; Queen's University and Kingston General Hospital, Kingston, Ontario; McMaster University, Hamilton, Ontario; Royal North Shore Hospital and the University of Sydney, Australia.

"We suggest that policy makers reconsider recommendations promoting the use of intensive insulin therapy in all critically ill patients," write the authors. However, because the study included data from trials in different populations with varied illness severity, they "cannot exclude the possibility that some patients may benefit from intensive insulin therapy and be at less risk of hypoglycemic events."

In a related commentary, Dr. Greet Van den Berghe and colleagues argue that differences in specific elements of how intensive insulin therapy was delivered account for the varying findings of individual studies and that a single guideline for intensive insulin therapy applicable to all patients is not appropriate.


Story Source:

The above story is based on materials provided by Canadian Medical Association Journal. Note: Materials may be edited for content and length.


Journal References:

  1. Griesdale et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ, 2009; 180 (8): 821-827 DOI: 10.1503/cmaj.090206
  2. Van den Berghe et al. Intensive insulin therapy in the intensive care unit. CMAJ, 2009; 180 (8): 799-800 DOI: 10.1503/cmaj.090500
  3. The NICE-SUGAR Study Investigators. Intensive versus Conventional Glucose Control in Critically Ill Patients. N Engl J Med, 2009; DOI: 10.1056/NEJMoa0810625

Cite This Page:

Canadian Medical Association Journal. "NICE SUGAR: Intensive Insulin Therapy Risks." ScienceDaily. ScienceDaily, 24 March 2009. <www.sciencedaily.com/releases/2009/03/090324081429.htm>.
Canadian Medical Association Journal. (2009, March 24). NICE SUGAR: Intensive Insulin Therapy Risks. ScienceDaily. Retrieved September 16, 2014 from www.sciencedaily.com/releases/2009/03/090324081429.htm
Canadian Medical Association Journal. "NICE SUGAR: Intensive Insulin Therapy Risks." ScienceDaily. www.sciencedaily.com/releases/2009/03/090324081429.htm (accessed September 16, 2014).

Share This



More Health & Medicine News

Tuesday, September 16, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com
Man Floats for 31 Hours in Gulf Waters

Man Floats for 31 Hours in Gulf Waters

AP (Sep. 16, 2014) A Texas man is lucky to be alive after he and three others floated for more than a day in the Gulf of Mexico when their boat sank during a fishing trip. (Sept. 16) Video provided by AP
Powered by NewsLook.com
Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

AFP (Sep. 16, 2014) Since the arrival of Ebola in Ivory Coast, Ivorians have been abandoning their pets, particularly monkeys, in the fear that they may transmit the virus. Duration: 00:47 Video provided by AFP
Powered by NewsLook.com
Study Links Male-Pattern Baldness To Prostate Cancer

Study Links Male-Pattern Baldness To Prostate Cancer

Newsy (Sep. 16, 2014) New findings suggest men with a certain type of baldness at age 45 are 39 percent more likely to develop aggressive prostate cancer. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

      Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins