Glycemic control has received intense scrutiny in the last decade as an important aspect of patient care. Earlier studies suggested that tight glycemic control (target level of 80 - 110 mg/dL) improved outcomes in intensive care unit (ICU) patients. Subsequent trials did not confirm the same benefit. Moreover, increased mortality was found in association with such tight control compared with a ...

Metabolic memory, the concept that historical glycemic control is a major determinant of diabetes complications, is of considerable interest not only to those involved in the care of people with diabetes mellitus but also to a wider audience, those wishing to understand the pathogenesis of hyperglycemia-related target organ damage. This phenomenon has been popularized clinically by the Diabetes...

Hyperglycemia occurs in patients with diabetes and in nondiabetic patients during acute illness. Epidemiologic and observational studies have demonstrated that hyperglycemia is associated with significant adverse outcomes. Nevertheless, studies evaluating the benefits of normalizing glycemia have produced inconsistent results. For instance, intensive control of hyperglycemia had been shown to p...

Critical illness hyperglycemia (CIH) is common in pediatric and adult intensive care units (ICUs). Children undergoing surgical repair or palliation of congenital cardiac defects are particularly at risk for CIH and its occurrence has been associated with increased morbidity and mortality in this population. Strict glycemic control through the use of intensive insulin therapy (IIT) has been sho...

IMPORTANCE There is substantial uncertainty about optimal glycemic control in older adults with type 2 diabetes mellitus. OBSERVATIONS Four large randomized clinical trials (RCTs), ranging in size from 1791 to 11,440 patients, provide the majority of the evidence used to guide diabetes therapy. Most RCTs of intensive vs standard glycemic control excluded adults older than 80 years, used surro...

Inpatient Glycemic Targets After publication of the initial van den Berghe trial in surgical intensive care patients,1 several professional organizations published guidelines supporting near-normal glycemic targets.8,9 Subsequent trials documented an increased risk for hypoglycemia with tight glycemic control, suggesting that more modest glycemic targets may be optimal.10–13 The Normoglycemia i...

AIMS Glycemic control and ophthalmological care are known to significantly diminish the risk of visual impairment and blindness by diabetic retinopathy (DRP). The (cost-)effectiveness of both strategies was studied to highlight their benefits for patients and care providers. METHODS A computer analysis was developed, following the progression of DRP and the effectiveness of metabolic control ...