Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Finney and colleagues1 concluded that "increased insulin administration
is positively associated with death in the ICU [intensive care unit] regardless
of the prevailing blood glucose level. Thus, control of glucose levels rather
than of absolute levels of exogenous insulin appear to account for the mortality
benefits associated with intensive insulin therapy demonstrated by others."
It is unclear, however, whether these conclusions apply equally to patients
who are admitted to the ICU for medical vs surgical diagnoses.
Moshenyat R, Kupfer YY, Tessler S. Exogenous Insulin and Hypoglycemia as Prognostic Factors in Critically Ill Patients. JAMA. 2004;291(5):558. doi:10.1001/jama.291.5.558-a