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Published at www.nejm.org March 24, 2009 (10.1056/NEJMe0901507)

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For the past decade, hospitals have focused on the inpatient management of hyperglycemia, particularly in the intensive care unit (ICU). Extensive observational data have shown a consistent, almost linear relationship between blood glucose levels in hospitalized patients and adverse clinical outcomes, even in patients without established diabetes.¹ It has never been entirely clear, however, whether glycemia serves as a mediator of these outcomes or merely as a marker of the sickest patients, who present with the well-known counterregulatory stress response to illness. Several early studies suggested a clinical benefit from strict glucose control during critical care but were weakened by . . . [Full Text of this Article]

Source Information

From the Sections of Endocrinology (S.E.I.) and Pulmonary and Critical Care Medicine (M.D.S.), Department of Internal Medicine, Yale University School of Medicine and Yale–New Haven Hospital, New Haven, CT.

This article (10.1056/NEJMe0901507) was published at NEJM.org on March 24, 2009. It will appear in the March 26 issue of the Journal.

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