Is ferrotoxicity a new great public health challenge?

adopt accuracy requirements more stringent than those resulting from simulations. Simulations are always based on assumptions, and unfortunately, a model is only a model. An extended version of the error model will remain another approach of reality. What is probably more important to reduce errors when defining clinically realistic accuracy thresholds is that our study, to the best of our knowledge, is the first that is based on glucose dynamics originating from real-life critically ill patients (i.e., independent of any mathematical glucoregulatory model and avoiding the associated errors). Further, clinical studies to validate a (new) glucose sensor should be appropriately designed (sufficient number of target patients, adequate reference sensor, etc.) to compare its accuracy performance to such thresholds. Next, glucose sensor accuracy thresholds do depend on the robustness of the control algorithm and should be specified (using simulations) for each individual glucose controller (1, 5). Generalization of these thresholds will underestimate errors for less robust glucose controllers and potentially harm patients ; it should be avoided, accordingly. Finally, we wish to underline the need for clinical trials investigating the combination glucose sensor/glucose controller (each with its specific characteristics) in a real-life critically ill setting to overcome the shortcomings typical of simulation studies. Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article. of effect of glucose sensor errors on insulin dosage and glucose bolus computed by LOGIC-insulin. Glucose meter performance criteria for tight glycemic control estimated by simulation modeling.