Using the glucometrics website to benchmark ICU glucose control before and after the NICE-SUGAR Study

Abstract

Background: Prior to 2009, intensive glycemic control was the standard in main intensive care units (ICUs). Glucose targets have been recalibrated after publication of the NICE-SUGAR study in that year, followed by updated guidelines that endorsed more moderated control. We sought to determine if the prevalence of hyperglycemia in US ICUs had increased after the NICE-SUGAR study's results were reported. Methods: We used data from hospitals submitted to the Yale Glucometrics website to assess mean blood glucose values, percentage of blood glucose within various ranges, and the prevalence of hypo-and hyperglycemic excursions, based on the patient-day method, comparing the pre-to post-NICE-SUGAR time period. Results: Among more than a total of 2 million blood glucose determinations, comprising 408 790 patient-days, median patientday blood glucose decreased from 144 mg/dL to 141 mg/dL (P <70 mg/dl) or severe hyperglycemia (ge;300 mg/dl) decreased during this time. Conclusions: Our results suggest that glycemic control in US ICUs has improved when comparing time periods before versus after publication of the NICE-SUGAR study. We found no evidence that fewer hypoglycemic events were achieved at the expense of more hyperglycemia.