CarbohydratesTight control of glycaemia in critically ill patientsPreiser, Jean-Charlesa; Devos, Philippeb; Van den Berghe, Greetc Author Information Departments of Intensive Care of aRHMS Tournai and Erasme University Hospital, Brussels, bUniversity Hospital Sart-Tilman, Liège and cUniversity Hospital Gasthuisberg and Catholic University of Leuven, Belgium Correspondence to Jean-Charles Preiser MD, PhD, Head, Department of Intensive Care, RHMS Tournai, 80 chaussée de Saint-Amand, 7500 Tournai, Belgium. Tel: +32 6988 5273; fax: +32 6988 5295; e-mail: [email protected] Current Opinion in Clinical Nutrition and Metabolic Care: September 2002 - Volume 5 - Issue 5 - p 533-537 Buy Abstract Purpose of review This manuscript attempts to review the effects associated with hyperglycaemia in critically ill patients and the effects of various insulin regimens. The available clinical findings and pertinent experimental data are examined. Recent findings Intensive insulin therapy titrated to maintain blood glucose level between 4.4 and 6.1 mmol/l during intensive care unit stay has recently been shown to significantly decrease mortality, septic morbidity, sepsis-related organ failure, transfusion requirements and polyneuropathies. Prior studies have already documented that hyperglycaemia on admission is related to susceptibility to infections and worse outcomes following myocardial and cerebral ischaemic events. Additional effects of insulin, unrelated to the control of glycaemia, have also been reported. Summary Intensive insulin therapy is probably warranted in most categories of critically ill patients, although some of the underlying mechanisms of its beneficial effects still need to be elucidated. © 2002 Lippincott Williams & Wilkins, Inc.