Glucose Control in Patients Questioned
2008-08-27 07:16:24.0
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(Ivanhoe Newswire) -- A recent study sheds new light on the standard hospital practice of glucose control. The study indicates that for critically ill patients, striving to keep blood glucose at normal levels doesn’t significantly reduce risk of death in the hospital, and actually increases the risk of low blood sugar.
Many professional societies, like the American Diabetes Association, recommend tight glucose control in all critically ill adult patients.
Researchers analyzed 29 randomized, controlled trials to examine the risks and benefits of tight glucose control in critically ill adults. They found no significant difference between hospital mortality with tight glucose control, or keeping blood glucose at less than 150 mg/dL, and normal care. Glucose control did significantly decrease the risk of septicemia -- and increase the risk of hypoglycemia, or low blood sugar, by five times.
A 2001 study showed tight glucose control reduced the risk of death in critically ill surgical patients by one-third. Some subsequent studies have failed to show this benefit and suggested an increased risk of developing hypoglycemia.
Commenting on the study, Simon Finfer, M.B.B.S., F.J.F.I.C.M., of The George Institute for International Health and Anthony Delaney, M.B.B.S., F.J.F.I.C.M., of the Royal North Shore Hospital in Sydney, Australia, wrote it’s too soon to make conclusions on the issue of glucose control.
“There is no simple or clear answer to the complex problem of glycemic control in critically ill adults,” they wrote. “At present, targeting tight glycemic control cannot be said to be either right or wrong.”
SOURCE: Journal of the American Medical Association, 2008;300:933-944
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