Moving beyond tight glucose control to safe effective glucose control

The impressive benefits related to the use of tight glucose control by intensive insulin therapy have not been reproduced until now in multicenter large-scale prospective randomized trials. Although the reasons for these failures are not entirely clear, we suggest the use of a stepwise approach - Safe, Effective Glucose Control - that will essentially target an intermediate blood glucose level. As compared with genuine tight glucose control, Safe, Effective Glucose Control - already used in many intensive care units worldwide - is intended to decrease the rate of hypoglycemia and the workload, while reducing the adverse effects of severe hyperglycemia.