Blood glucose control in the intensive care unit: discrepancy between belief and practice

A survey among pediatric intensive care physicians showed that a great disparity exists between physicians' beliefs regarding hyperglycemia in critically ill patients and their daily practices to screen and treat hyperglycemia. One of the most prominent reasons for hesitating to implement tight glycemic control is the fear of evoking iatrogenic hypoglycemia. Results from ongoing and future studies focusing on both short- and long-term effects of tight glycemic control in broad populations of critically ill children can provide further strong evidence for implementing tight glycemic control. Improving the accuracy of bedside blood glucose measurements and developing reliable computer algorithms to steer insulin infusions can help to overcome the fear of evoking iatrogenic hypoglycemia.