GLUCONTROL
Trial question
Is intensive glucose control superior to intermediate glucose control in patients in the ICU?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
37.0% female
63.0% male
N = 1078
1078 patients (400 female, 678 male).
Inclusion criteria: adult patients admitted to medical or surgical ICUs.
Key exclusion criteria: life expectancy below 24 hours; absence of informed consent.
Interventions
N=536 intensive glucose control (blood glucose target 4.4-6.1 mmol/L).
N=542 intermediate glucose control (blood glucose target 7.8-10.0 mmol/L).
Primary outcome
Death from any cause in intensive care unit
17.2%
15.3%
17.2 %
12.9 %
8.6 %
4.3 %
0.0 %
Intensive glucose
control
Intermediate glucose
control
No significant
difference ↔
No significant difference in death from any cause in the ICU (17.2% vs. 15.3%; AD 1.9%, 95% CI -2.55 to 6.35).
Secondary outcomes
No significant difference in death from any cause at day 28 (18.7% vs. 15.3%; AD 3.4%, 95% CI -1.11 to 7.91).
No significant difference in death in the hospital at day 28 (23.3% vs. 19.4%; AD 3.9%, 95% CI -0.88 to 8.68).
Borderline significant increase in median length of stay in the ICU (6 days vs. 6 days).
Safety outcomes
Significant difference in hypoglycemia (8.7% vs. 2.7%).
Conclusion
In adult patients admitted to medical or surgical ICUs, intensive glucose control was not superior to intermediate glucose control with respect to death from any cause in the ICU.
Reference
Jean-Charles Preiser, Philippe Devos, Sergio Ruiz-Santana et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009 Oct;35(10):1738-48.
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