Calls to tackle variation in glycaemic control

Since the landmark Leuven study in 2001,1 numerous studies have been published on the role of glycaemic control. The emerging picture is that while treating hyperglycaemia could be beneficial, normoglycaemic control carries a risk of unwanted hyperglycaemic injury through over control and can lead to marked variability in glucose levels, which is associated with poorer outcomes.2 

The issue of variability was recently discussed at the Intensive Care Society State of the Art Meeting, following a major comparative survey of practices across 90 adult ICU departments in the UK, Germany and the Benelux. Gavin Troughton PhD and David Edbosimba Msc, from Sphere Medical presented the findings as part of a presentation and scientific poster.3

Elevated blood glucose is a widely recognised response to critical illness, with around two thirds of patients admitted to the intensive care unit (ICU) requiring intravenous insulin therapy (IIT) in order to avoid hyperglycaemia. However, IIT also carries the risk of hypoglycaemic episodes and injury. Sphere’s study involved intensivists from 90 adult intensive care units (ICU) and aimed to understand the current practices, protocols and challenges of glycaemic control practice using IIT.