Hyperglycemia is a common finding in hospitalized patients and has been associated with worsened outcomes in a variety of inpatient subpopulations. The use of insulin to control blood glucose has been advocated as a way to improve health outcomes in hospitalized patients with hyperglycemia, but the evidence for the efficacy of this approach and the thresholds for initiating insulin management are unclear.
The key questions were:
Does strict blood glucose control compared to less strict blood glucose control improve final health outcomes in the following patients?
patients in the medical intensive care unit
patients in the surgical intensive care unit
acute myocardial infarction patients
acute stroke patients
post coronary artery bypass graft patients
general surgical ward patients
general medicine ward patients
What are the harms of strict blood glucose control in the above subpopulations?
What are the most effective and safest means of normalizing blood glucose in the above subpopulations?