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Editorials |

Glycemic Control in Critically Ill Patients : Leuven and Beyond

James Krinsley, MD, FCCP
Author and Funding Information

Affiliations: Stamford, CT ,  Dr. Krinsley is Director of Critical Care, Stamford Hospital and Associate Professor of Medicine, Columbia University College of Physicians and Surgeons.

Correspondence to: James Krinsley, MD, FCCP, Department of Medicine, Stamford Hospital, 190 W Broad St, Stamford, CT 06902; e-mail: jkrinsley@stamhealth.org



Chest. 2007;132(1):1-2. doi:10.1378/chest.07-0834
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This editorial will start with a confession. Before November 8, 2001, glucose monitoring in critically ill patients was not “on my radar screen.” As an ICU director, I followed the general principles learned during my residency: hyperglycemia occurred commonly in this patient population, was very likely protective, and should not be treated unless it became excessive, perhaps above the level of 200 to 225 mg/dL. The experience that day of reading the first Leuven study1 was, for me, startling and life changing. The following morning, I challenged the comprehensive database created in my ICU to identify a relationship between glycemic levels during ICU admission and mortality and found that even modest degrees of hyperglycemia were associated with increased risk.2

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