Navigation Links
NICE SUGAR: Intensive insulin therapy risks
Date:3/24/2009

OTTAWA, ONTARIO, CANADA Intensive insulin therapy significantly increases the risk of hypoglycemia in critically ill patients, found a new study in CMAJ (http://www.cmaj.ca/press/cmaj.090206.pdf).

Intensive insulin therapy is used in many intensive care units around the world as a means to tightly regulate blood sugar. Although labour intensive, it has been recommended as a standard of care for critically ill patients by many organizations including the American Diabetes Association and the American Association of Clinical Endocrinologists.

A randomized trial in 2001 reported that intensive insulin therapy significantly reduced hospital mortality, although subsequent trials have reported inconsistent effects on mortality and higher rates of severe hypoglycemia.

The CMAJ study includes data from 26 trials, including the NICE-SUGAR Study on intensive insulin therapy, an international, multicentre randomized trial that is the largest intensive insulin therapy trial to date. The NICE-SUGAR study is published online in the New England Journal of Medicine March 24, 2009 and March 26 for the print edition.

"By including the largest trial on intensive insulin therapy published to date, we provide the most current and precise estimate of the effect of intensive insulin therapy on vital status and hypoglycemia in the ICU setting," write Dr. Donald Griesdale, anesthesiologist and critical care physician at Vancouver General Hospital and clinical instructor at the University of British Columbia, and coauthors.

The CMAJ study looked at 26 trials involving 13 567 patients. There was a 6-fold increased risk of hypoglycemia compared to the control treatment.

The study was conducted by researchers from the University of British Columbia and Vancouver General Hospital, Vancouver, BC; Harvard School of Public Health, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston, Mass; Queen's University and Kingston General Hospital, Kingston, Ontario; McMaster University, Hamilton, Ontario; Royal North Shore Hospital and the University of Sydney, Australia.

"We suggest that policy makers reconsider recommendations promoting the use of intensive insulin therapy in all critically ill patients," write the authors. However, because the study included data from trials in different populations with varied illness severity, they "cannot exclude the possibility that some patients may benefit from intensive insulin therapy and be at less risk of hypoglycemic events."

In a related commentary (http://www.cmaj.ca/press/cmaj.090500.pdf), Dr. Greet Van den Berghe and colleagues argue that differences in specific elements of how intensive insulin therapy was delivered account for the varying findings of individual studies and that a single guideline for intensive insulin therapy applicable to all patients is not appropriate.


'/>"/>

Contact: Kim Barnhardt
kim.barnhardt@cmaj.ca
613-731-8610 x2224
Canadian Medical Association Journal
Source:Eurekalert

Related medicine news :

1. Dallas To Host Intensive Norvax University Insurance Agent Sales Training and Web Marketing Conference on March 26
2. New Anxiety and Mood Disorders Intensive Treatment Program in Downtown Chicago
3. Intensive Resource Group (IRG) Helps Hospitals Address Financial and Operational Crisis
4. Intensive Insulin Therapy Reduces Mortality in Sick Kids
5. Intensive support programs can help hospitalized smokers stay smoke-free
6. Integrated Medical Systems Receives FDA Clearance for Worlds First Suitcase Intensive Care Unit
7. New Intensive Care Unit at Gilbert Hospital Sees First Patient
8. WellPoint Partners With CareNex Health Services to Expand Its Neonatal Intensive Care Services Program
9. Newborns in Intensive Care Often Exposed to Pain
10. Less Intensive Treatment Given Diabetic Women With Heart Disease
11. Cystic Fibrosis Foundation Hosts Quality Improvement Summit - Caregivers from 15 States and Canada Gather in Hartford for Intensive Learning
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/8/2016)... , ... December 08, 2016 , ... ... Research Institute (WCRI) officially opened registration today for its 33rd Annual Issues ... Boston, MA . , The theme of the conference is “Persistent Challenges and ...
(Date:12/8/2016)... Pa. (PRWEB) , ... December 08, 2016 , ... ... Medicine Southern Chester County, a Property owned by an affiliate of Seavest, has ... square foot Penn Medicine Southern Chester County ambulatory care center (ACC) was named ...
(Date:12/8/2016)... ... December 08, 2016 , ... With the increasing demand for dental implants, the ... (WIYM) campaign to inform dentists and patients about the safety issues related to dental ... market in the U.S. is projected to reach $6.4 billion in 2018 with more ...
(Date:12/8/2016)... ... December 08, 2016 , ... ... access for customers and employees that are both engaging and easy to use. ... Smart Technology, the software company revealed today its plans to roll out new ...
(Date:12/8/2016)... ... December 08, 2016 , ... ... has been recognized for adherence to the highest standards of trauma, maternity, ... organizations, announced the center's president and CEO, Dr. Daniel Messina. , Among the ...
Breaking Medicine News(10 mins):
(Date:12/9/2016)... , Dec. 9, 2016   Hudes Laser ... December featuring the multi-wavelength Astanza Trinity laser and ... specializes in laser tattoo removal, IPL hair removal, ... ultrasound therapy. Hudes Laser Aesthetica is setting high ... and promises to deliver effective, long-lasting ...
(Date:12/9/2016)... OSAKA, Japan , Dec. 9, 2016 ... ; President & Representative Director, CEO: Dr. ... with amyotrophic lateral sclerosis (ALS) given edaravone intravenously in ... functional loss as measured by the ALS Functional Rating ... th International Symposium on ALS/MND in ...
(Date:12/9/2016)... 9, 2016  Axovant Sciences Ltd. (NYSE: ... focused on the treatment of dementia, today announced ... Phase 2b trial evaluating treatment with intepirdine (RVT-101), ... donepezil plus placebo in people with mild-to-moderate Alzheimer,s ... intepirdine to treatment was associated with reduced progression ...
Breaking Medicine Technology: