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NICE-SUGAR
About the Trial
The Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation trial randomized 6,104 ICU patients to intensive glucose control, target 81 to 108 mg per dL, or conventional target under 180. Intensive control increased 90 day mortality from 24.9 to 27.5 percent and caused far more severe hypoglycemia, 6.8 versus 0.5 percent. The trial reversed enthusiasm from the 2001 Leuven study by Van den Berghe, which had suggested tight control saved lives, particularly in surgical patients. After NICE SUGAR, guidelines moved toward moderate ICU glucose targets, roughly 140 to 180 mg per dL, rather than normal values. A cautionary tale about generalizing single center results.
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