Article preview from IN VIVO - September, 2012
Over a decade ago, the New England Journal of Medicine published a study identifying tight glycemic control in the intensive care unit as a critical step to improving outcomes. Today, GlySure and others are working on continuous glucose monitoring for the critical care environment to help deliver on that promise.
Article preview from IN VIVO - September, 2012
Late night giant David Letterman might have made the Top 10 List famous but the New England Journal of Medicine publishes a noteworthy top 10 list of its own that identifies the most frequently cited articles in the journal’s history. At number five sits a 2001 article “Intensive Insulin Therapy in Critically Ill Patients,” which makes a compelling case for adding the management of blood glucose levels in critical care patients to the list of mandatory care.
Lead author Greet Van den Berghe, MD, PhD (then head of the department of intensive care medicine at the hospital of the Catholic University of Leuven, Belgium) and her team studied hyperglycemia and insulin resistance in critically ill patients. This is a common phenomenon in patients in the intensive care unit (ICU), even in patients who have not previously had diabetes.
In Van den Berghe’s study of 1,548 patients in the surgical intensive care unit, the administration of intensive insulin therapy to normalize blood glucose levels had dramatic effects. Mortality dropped by 34% in the tight glycemic control (TGC) group. TGC patients experienced a 41% reduction in acute renal failure, and a 50% reduction in the need for blood transfusion. Sepsis dropped 46% in the study, potentially reducing one of the more expensive complications for US hospitals, especially since the Centers for Medicare and Medicaid Services shifted the burden of some hospital-acquired infections to hospitals.
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