Intensive insulin treatment reduced mortality and morbidity in critically ill patients.

Intervention Patients were assigned to receive intensive (n=765) or conventional (n=783) insulin treatment. Intensive treatment was insulin infusion that was started if the blood glucose concentration was > 6.1 mmol/l, and was adjusted to maintain a blood glucose concentration of 4.4–6.1 mmol/l (maximum insulin dose 50 IU/h). Conventional treatment was continuous insulin infusion by a pump that was started if the blood glucose concentration was > 11.9 mmol/l and adjusted to maintain a blood glucose concentration between 10.0 and 11.1 mmol/l. All patients were fed continuous intravenous glucose upon ICU admission. Total parenteral, combined parenteral and enteral, or total enteral feeding was started the next day. Total enteral feeding was attempted as early as possible.