Endocrine Insider
April 1, 2009

The Endocrine Society issued a statement on the findings of the Normoglycemia in Intensive Care Evaluation – Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study released last week in the New England Journal of Medicine (NEJM). The Society commends the NICE-SUGAR investigators for producing an important and provocative addition to the medical literature, which suggests that near-normalization of blood sugar does not clearly improve outcomes in all critically ill hyperglycemic ICU patients, and that such an approach may worsen outcomes, possibly leading to death.
Based on this counterintuitive finding it appears that looser control of hyperglycemia (blood glucose values of 144-180 mg/dl as defined in the study) may be a reasonable and perhaps preferable option in caring for this group of very sick patients. 

The Endocrine Society believes that we have entered an era of more nuanced and patient-appropriate recommendations as a result of this and other recent large, well-done outpatient and inpatient studies.  Until there is greater insight into these findings, the Society suggests that physicians should individually tailor their approach to glycemic control in their ICU patients by perhaps targeting glucose values between 144-180 mg/dl.

To read the full text of the Society’s statement, please click here.