Arabi YM, Tamim HM, Dhar GS et al.
Kind Saudi Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Am J Clin Nutr 2011;93:569–77.
Editor’s note: An article by Van den Berghe et al. on intensive insulin therapy in the intensive care unit (ICU), published in the New England Journal of Medicine (N Engl J Med 2001;345:1359–67), has been largely responsible for the recent surge in the number of trials into the effects of glucose control in the ICU. One criticism of this groundbreaking study has been that the level of nutritional support provided to the surgical patients treated in this way was at a relatively high caloric content. Critics of the intensive insulin policy in the ICU have therefore highlighted the possibility that the improvement seen in this patient group may not have been related to insulin therapy per se, but related to insulin correction of an excessive caloric intake for their clinical condition. The ensuing randomized controlled trials failed to show a clear clinical outcome benefit, including a trial that was highlighted in the current paper (Crit Care Med 2008;36:190–7).