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Updated: Jul 17, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Tight glucose control in the ICU: how aggressive should we be?]
1Service de médecine intensive adulte, CHUV, 101I Lausanne. mauro.oddo@chuv.ch
Revue Medicale Suisse
|January 24, 2007
Summary
Intensive insulin therapy shows benefits for cardiac surgery patients but poses risks like hypoglycemia for others. A less aggressive glucose control approach is recommended for most critically ill patients pending further research.
Area of Science:
- Critical care medicine
- Endocrinology
- Metabolic disorders
Context:
- Glycemic control in intensive care units (ICUs) is a complex issue.
- Intensive insulin therapy (IIT) is beneficial for specific patient groups, notably post-cardiac surgery.
- Concerns exist regarding IIT's efficacy and safety in medical, septic, post-traumatic, and brain-injured patients.
Purpose:
- To review the current evidence on tight glucose control in critical care.
- To evaluate the risks and benefits of intensive insulin therapy across different critically ill populations.
- To inform optimal blood glucose targets in diverse ICU settings.
Summary:
- Evidence supports IIT in post-operative cardiac surgery patients.
- IIT has not shown mortality benefits and increases hypoglycemia risk in other critically ill groups.
- Optimal blood glucose targets may vary based on underlying patient pathology.
Impact:
- Suggests a less aggressive glucose control strategy is preferable for most critically ill patients.
- Highlights the need for further multi-center studies with heterogeneous cohorts.
- Emphasizes defining individualized glycemic targets in critical care practice.
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