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This meta-analysis evaluates the effects of intensive insulin therapy on 90-day mortality rates and hypoglycemia incidents in ICU settings. Analyzing data from 26 trials involving 13,567 patients, the results indicate no overall effect on mortality (pooled RR 0.93). However, a significant increase in hypoglycemia risk (RR 6.0) was observed in 14 trials with 12,347 patients. Notably, intensive insulin therapy demonstrated a mortality benefit in surgical ICUs (RR 0.63), while no such benefit was found in medical/mixed ICUs (RR 1.00).
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Meta-Analysis ICU Intensive Insulin Includes NICE-SUGAR • 90 day mortality—no overall effect (pooled RR 0.93) • 26 trials (n=13,567) • ↑ Risk hypoglycemia (RR 6.0) • 14 trials (n=12,347) • Benefit surgical ICUs (RR 0.63) • 5 trials (n=1,972) • Majority VBG SICU study • No benefit medical/mixed ICUs (RR 1.00) Griesdaleet al., Can Med Assoc J. 2009;180:821