A new study reported online March 24 in the New England Journal of Medicine reveals that lowering blood glucose levels in critically ill patients is found to increase mortality by 10 percent. The researchers involved in the study suggest a review of current guidelines about blood sugar levels needed in ICU patients.

 

“Intensively lowering blood glucose in critically ill patients is not beneficial and may be harmful,” Chief Investigator, Professor Simon Finfer from The George Institute for International Health said.

 

For the study Prof. Finfer and colleagues from multiple international groups followed 6104 critically ill patients in Canada, New Zealand, the USA and Australia for ninety days, using a computerized algorithm. The patients were randomized either to an intensive control target (81-108mg/dL; 4.5-6.0 mmol/L) or a conventional control target (<= 180mg/dL; 10.0 mmol/L). Control of blood glucose was achieved by the use of an intravenous infusion of insulin.

 

At the end of the study, 829 patients (27.5 percent) in the intensively controlled groups and 751 (24.9 percent) in the conventionally controlled group had died. Cardiovascular failure was the main cause of death in the intensively controlled group. Severe hypoglycemia was diagnosed in 206 of 3,016 patients (6.8 percent) in the intensively controlled group and 15 of 3,014 (0.5 percent) in the conventionally controlled group, the researchers report.

 

The results of study clearly indicate that international clinical guidelines need urgent review. “Based on our findings, we do not recommend pursuing a normal blood glucose level in critically ill patients. We found that intensively lowering blood glucose levels increased a patient's risk of dying by 10%,” Prof. Finfer said.