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Joint Statement from the American Diabetes Association and American Association of Clinical Endocrinologists on the NICE-SUGAR Study on Intensive Versus Conventional Glucose Control in Critically Ill Patients
Date:3/24/2009

Response to March 24 article in the New England Journal of Medicine

ALEXANDRIA, Va. and JACKSONVILLE, Fla., March 24 /PRNewswire-USNewswire/ -- A study published online today in the New England Journal of Medicine suggests that intensive blood glucose (sugar) control for critical care patients with hyperglycemia (high blood glucose) does not improve outcomes and is associated with an increase in deaths.

(Logo: http://www.newscom.com/cgi-bin/prnh/20090324/DC88061LOGO-a)

(Logo: http://www.newscom.com/cgi-bin/prnh/20090324/DC88061LOGO-b)

The American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) maintain that the findings of the Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study should NOT lead to an abandonment of the concept of good glucose management in the hospital setting. Uncontrolled high blood glucose can lead to serious problems for hospitalized patients, such as dehydration and increased propensity to infection.

It is important to consider that the severely ill patients in this trial were treated intensively with intravenous insulin to very tight targets (average of 115 mg/dl), and were compared to a control group whose glucose control was good (average glucose 144 mg/dl).

The ADA and AACE caution against letting this study swing the pendulum of glucose control too far in the other direction where providers in hospitals are complacent about uncontrolled hyperglycemia. The two organizations maintain that strategies must be identified to help hospitals establish structured protocols for safe and effective management of blood glucose in both int
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SOURCE American Association of Clinical Endocrinologists; American Diabetes Association
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