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December 17, 2008

Tight Glucose Control in Critically Ill Adults

JAMA. 2008;300(23):2725-2728. doi:10.1001/jama.2008.816

To the Editor: The meta-analysis by Dr Soylemez Weiner and colleagues1 suggested limited benefits, if any, of tight glucose control in critically ill adults and a 3- to 5-fold increased risk of hypoglycemia. The accompanying Editorial by Drs Finfer and Delaney2 discussed the findings in relation to the study by van den Berghe et al,3 which demonstrated that tight glucose control reduced mortality by one-third in surgical ICU patients. The Editorial briefly mentioned the possibility of inaccurate bedside glucose testing. We suggest that this concern should be considered more carefully.