Table 1.

Clinical trials evaluating the impact of different targets of acute glycemic control in critically ill and septic patients

Authors	Year	Patients	Study design	Main findings
Trials showing benefits on mortality in patients on tight glycemic control
Van den Berghe et al. [45]	2001	1,548 surgical (63% cardiac) ICU patients receiving mechanical ventilation (the number of septic patients not reported; 204 diabetic patients)	Prospective, randomized, controlled trial	TGC versus 180–200 mg/dl: Lower overall ICU mortality (8.0% vs. 4.6%, p < 0.04) due to benefit in patients staying in the ICU for > 5 days (10.6% vs. 20.2%, p = 0.005) Greater reduction in mortality observed in septic patients with multiple-organ failure 34% lower overall in-hospital mortality No impact on mortality in diabetic patients
Trials showing benefits on mortality in patients on less stringent glycemic control
Van den Berghe et al. [46]	2006	1,200 medical ICU patients considered in need of ICU for ≥ 3 days (total number of septic patients not reported, but sepsis reported as a major trigger for admission to ICU; 203 diabetic patients)	Pospective, randomized, controlled trial	TGC versus 180–200 mg/dl: No overall difference in mortality (37.3% vs. 40%, p = 0.33) In patients staying in the ICU for ≥ 3 days lower in-hospital mortality (reduction of in-hospital mortality from 52.5% to 43%, p = 0.009) but higher rate of hypoglycemic episodes No impact on mortality in diabetic patients Lower overall morbidity (prevention of acquired AKI, earlier weaning from mechanical ventilation, and earlier discharge from the medical ICU and the hospital—but no detectable reduction in bacteremia)
Brunkhorst et al. [48]	2008	537 patients with severe sepsis/septic shock (163 diabetic patients)	multicenter, randomized trial	TGC vs. 180–200 mg/dl: Higher rate of severe hypoglycemia (17.0% vs. 4.1%, p < 0.001) and serious adverse events (10.9% vs. 5.2%, p = 0.01) No difference in 28-day nor 90-day mortality No difference in survival between patients with and without diabetes
Preiser et al. [47]	2009	1,001 medico-surgical ICU patients (445 medical patients—number of septic patients not reported; 203 diabetic patients)	Prospective, randomized, multi-center, controlled trial (Glucontrol Study)	TGC versus 140–180 mg/dl: Higher rate of hypoglycemia (8.7% vs. 2.7%, p < 0.0001) No difference in ICU, in-hospital and 28-day mortality No association between mortality and diabetes
Finfer et al. [22]	2009	6,104 medico-surgical ICU patients considered in need for ICU for ≥ 3 days (1,302 patients with severe sepsis; 1,211 diabetic patients)	Large, international, randomized trial (NICE-SUGAR Trial)	TGC versus ≤ 180 mg/dl: Higher 90-day mortality (OR 1.14 [95% CI 1.0–1.3]) without differences among medical and surgical patients (OR respectively 1.3 and 1.1, p = 0.10) No difference in mortality between patients with and without diabetes Higher rate of severe hypoglycemia (6.8% vs. 0.5%, p < 0.001)

Citations are in order of publication date

ICU = Intensive Care Unit; TGC = Tight Glucose Control (blood glucose levels targeted to 80–110 mg/dl)