Resuscitation
Volume 74, Issue 1 , Pages 191-193, July 2007

Intensive insulin therapy in the ICU: Is it now time to jump off the bandwagon?☆

  • Paul E. Marik

      Affiliations

    • Pulmonary and Critical Care, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, United States
    • Corresponding Author InformationCorresponding author. Tel.: + 1 215 955 1672; fax: +1 215 955 0830.
    • ,
  • Joseph Varon

      Affiliations

    • The University of Texas Health Science Center at Houston, Houston, TX 77030, United States
    • The University of Texas Medical Branch at Galveston, Houston, TX 77030, United States

Received 20 December 2006; received in revised form 1 January 2007; accepted 1 January 2007. published online 31 March 2007.

Summary 

Following the publication of the Leuven Intensive Insulin Therapy (IIT) study in 2001, tight glycemic control has become regarded as the standard of care in intensive care units throughout the world. The Leuven IIT study, was however, an unblinded, single center study with unique patient and institutional characteristics that may not extrapolate to practice elsewhere in the world. Indeed, recent randomized controlled studies have been unable to demonstrate any benefit from tight glucemic control. We suggest that the widespread adoption of tight glycemic control be abandoned at this time.

Keywords: Hyperglycemia, Parenteral nutrition, ICU, Critical care, Insulin, Hypoglycemia, Mortality

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☆ A Spanish translated version of the summary of this article appears as Appendix in the final online version at 10.1016/j.resuscitation.2007.02.011.

PII: S0300-9572(07)00037-8

doi:10.1016/j.resuscitation.2007.01.023

Resuscitation
Volume 74, Issue 1 , Pages 191-193, July 2007

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