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Controlling blood sugar improves survival: Study
Belgian researchers found that using insulin to keep blood sugar levels close to normal when a patient first arrives at a hospital`s intensive care unit dramatically improves survival rates.
Belgian researchers found that using insulin to keep blood sugar levels close to normal when a patient first arrives at a hospital`s intensive care unit dramatically improves survival rates.
Reporting in Thursday’s ‘New England’ journal of medicine, the research team headed by Dr Greet Van Den Berghe of Catholic University of Leuven, Belgium, also found patients whose blood sugar levels were kept in check had fewer infections, fewer cases of kidney failure and required fewer blood transfusions.
And those who received insulin also tended to leave the intensive care unit sooner than those whose sugar levels were allowed to remain higher. The team`s results are based on the observation that critically ill diabetics do better when their blood sugar levels are tightly controlled. Knowing that otherwise healthy ICU patients also tend to experience temporary signs of diabetes, Van Den Berghe`s team spent a year focusing on the blood sugar levels in people in the ICU who were on a respirator. The 765 patients who received aggressive treatment got insulin as soon as their blood sugar levels exceeded 110 milligrams per deciliter. The normal range is 80 to 110. The rest of the patients did not get insulin therapy until their levels exceeded 215, and even then their blood sugar readings were kept between 180 and 200. The aggressive treatment made a big difference, the researchers found, reducing the death rate by 32 percent. The risk of bloodstream infections dropped by 46 percent. Kidney failure rates declined by 41 percent. And the number of transfusions was cut in half. The findings were so dramatic, the study was ended ahead of schedule because it seemed unethical to let patients stay in intensive care without receiving aggressive insulin treatment.
In an editorial in the journal, Dr Timothy W Evans of the Royal Brompton Hospital in London said that the Van Den Berghe team produced an ``impressive study.`` However, most of the patients had received only one type of surgery -- heart surgery -- and the hospital staff knew who was getting aggressive treatment and who was not, which might have influenced the outcome. ``The results therefore cannot be readily extrapolated to patients in non-surgical intensive care units or to those with other types of critical illness,`` Evans said. Until further research is done, adopting aggressive insulin treatment ``would be premature.
Bureau Report
Reporting in Thursday’s ‘New England’ journal of medicine, the research team headed by Dr Greet Van Den Berghe of Catholic University of Leuven, Belgium, also found patients whose blood sugar levels were kept in check had fewer infections, fewer cases of kidney failure and required fewer blood transfusions.
And those who received insulin also tended to leave the intensive care unit sooner than those whose sugar levels were allowed to remain higher. The team`s results are based on the observation that critically ill diabetics do better when their blood sugar levels are tightly controlled. Knowing that otherwise healthy ICU patients also tend to experience temporary signs of diabetes, Van Den Berghe`s team spent a year focusing on the blood sugar levels in people in the ICU who were on a respirator. The 765 patients who received aggressive treatment got insulin as soon as their blood sugar levels exceeded 110 milligrams per deciliter. The normal range is 80 to 110. The rest of the patients did not get insulin therapy until their levels exceeded 215, and even then their blood sugar readings were kept between 180 and 200. The aggressive treatment made a big difference, the researchers found, reducing the death rate by 32 percent. The risk of bloodstream infections dropped by 46 percent. Kidney failure rates declined by 41 percent. And the number of transfusions was cut in half. The findings were so dramatic, the study was ended ahead of schedule because it seemed unethical to let patients stay in intensive care without receiving aggressive insulin treatment.
In an editorial in the journal, Dr Timothy W Evans of the Royal Brompton Hospital in London said that the Van Den Berghe team produced an ``impressive study.`` However, most of the patients had received only one type of surgery -- heart surgery -- and the hospital staff knew who was getting aggressive treatment and who was not, which might have influenced the outcome. ``The results therefore cannot be readily extrapolated to patients in non-surgical intensive care units or to those with other types of critical illness,`` Evans said. Until further research is done, adopting aggressive insulin treatment ``would be premature.
Bureau Report