Page 526 - fbkCardioDiabetes_2017

502 Hyperglycemia & Glycemic Control In ICU

Hyperglycemia

What is NICE-SUGAR ? “TIGHT GLUCOSE EXPRESS” WAS
UNSTOPPABLE

DESCRIPTION
3054 patients were assigned to the intensive con-
trol group and 3050 to the conventional control
group.829 patients(27.5%) died in the intensive con-
trol group and 751(24.9%) in the conventional-control
group which is a difference between surgical vs. med-
ical ICU patients.
Severe hypoglycemia (<40 mg/dL) was recorded in
6.8% of patients in the intensive control group, vs.
0.5% in the conventional group.
POSITIVE POINTS :-

• Large multi-center study.
• Robust statistical analysis.
• Use of a uniform insulin protocol between sites.
• The primary outcome in this is unbiased.
• It was an Open Label RCT, Multinational
• 6104 critically ill patients were studied for Intensive • Good representation of critically ill patients
Insulin infusion (81-108 mg/dL) vs “Conventional” • Enrolled more patients than trials that preceded it.
control (144 – 180 mg/dL)
• 90 day survival – primary end point LIMITATIONS:-
More patients in the IIT group received corticosteroids
which could effect the variable were studying

GCDC 2017