• Jean-Charles Preiser, Philippe Devos, and Greet Van den Berghe.
• Department of Intensive Care of RHMS Tournai and Erasme University Hospital, Brussels, Belgium. preiserj@ulb.ac.be
• Curr Opin Clin Nutr Metab Care. 2002 Sep 1;5(5):533-7.

Purpose Of ReviewThis manuscript attempts to review the effects associated with hyperglycaemia in critically ill patients and the effects of various insulin regimens. The available clinical findings and pertinent experimental data are examined.Recent FindingsIntensive insulin therapy titrated to maintain blood glucose level between 4.4 and 6.1 mmol/l during intensive care unit stay has recently been shown to significantly decrease mortality, septic morbidity, sepsis-related organ failure, transfusion requirements and polyneuropathies. Prior studies have already documented that hyperglycaemia on admission is related to susceptibility to infections and worse outcomes following myocardial and cerebral ischaemic events. Additional effects of insulin, unrelated to the control of glycaemia, have also been reported.SummaryIntensive insulin therapy is probably warranted in most categories of critically ill patients, although some of the underlying mechanisms of its beneficial effects still need to be elucidated.

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