Trial reportThe New England journal of medicine2001
Intensive insulin therapy in critically ill patients.
Trial report in The New England journal of medicine, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 21 registered trials, which are not on this map. Cited by 2,155 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficay and Safety of Empagliflozin Versus Sitagliptin for the In-patient Management of Hyperglycemia: Randomised Control
KULeuven Intensive Insulin Therapy Study in Medical Intensive Care Patients
The Effect of Insulin Glargine on Glycemic Control, Morbidity, and Length of Stay in Hospitalized Subjects With Diabetes Receiving Enteral Nutrition
KULeuven Intensive Insulin Study in Pediatric Intensive Care Patients
Pilot Study Evaluating Use of Insulin-Glucose Algorithm and Glucose Monitoring Techniques to Control Hyperglycemia in the Pediatric Intensive Care Unit
GLUCOSE : Glucose Lowering by Usual Care Or Specialized Endocrinology Team
No Outcome Benefit for the Use of Intensive Insulin Therapy in the Critically Ill General and Vascular Surgical Patient. A Randomized Prospective Trial.
Impact of Tight Control of Perioperative Blood Glucose in Patients Undergoing Vascular Surgery on Their Perioperative Cardiovascular and Overall Morbidity and Mortality
Intensive Glucose Control Versus Conventional:Tendency Of Better Clinical Outcome In Open Heart Surgery
The Association Between Peri-Operative Hyperglycemia and Major Morbidity and Mortality
Impact of Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients
Evaluation of Corticosteroid Therapy in Childhood Severe Sepsis (Steroids in Paediatric Sepsis, StePS) - a Randomised Pilot Study
Barriers to the Implementation of Complete Insulin Order Sets in the Management of Individuals With Hyperglycemia or Diabetes at Park Nicollet Methodist Hospital
Real Time Continuous Glucose Monitoring With Glucoday® as an Assistant for Intensive Insulin Therapy in Diabetic Cardiothoracic Surgery Patients: a Randomized Study Comparing Blood Glucose Measurements Alone or Associated to Continue Glucose Monitoring
Randomised Clinical Trial to Evaluate the Obtention of Blood Samples Through an Arterial Catheter to Monitor Glycose Levels
Mechanisms of Insulin Resistance in Critical Illness: Role of Systemic Inflammation and GLP-1
LOGIC-Insulin Computerized Algorithm-guided Versus Nurse-directed Blood Glucose Control in Critically Ill Patients: the LOGIC-1 Randomized Controlled Trial
The Therapeutic Effects of Combination of Insulin With Berberine on the Patients With Stess Hyperlipemia:a Prospective, Double Blind, Randomized, Placebo-controlled, Single-center Clinical Trial
Impact of Tight Blood Glucose Control Within Normal Fasting Ranges With Insulin Titration Prescribed by the Leuven Algorithm in Adult Critically Ill Patients
Time in Glucose Hospital Target (TIGHT) - A Randomized Clinical Trial to Evaluate the Use of CGM to Achieve a Mean Glucose Target of 90 to 130 mg/dL Without Hypoglycemia in Hospitalized Adults With Type 2 Diabetes
Single-center, Proof of Concept, Prospective Study Evaluating the Utility of RELiZORB™ for the Treatment of Feeding Intolerance in Critically Ill Adults With Multi-Organ Failure
Who cites it
2,155 citing papers in PubMed, 7 syntheses or guidelines pooled it, 9,986 citations in OpenAlex.
- Brazilian Society of Oncologic Surgery Guideline for Bloodless Surgery (Part 1: Preoperative Strategies).Journal of surgical oncology · 2026Guideline
- Representation and reporting of patients with cancer in mortality-focused adult ICU randomized trials: a systematic review.BMC anesthesiology · 2026Pooled it
- Impact of tight blood glucose control on atrial fibrillation in critically ill patients receiving early parenteral nutrition: an individual patient data meta-analysis of two large randomized controlled trials.Journal of cardiothoracic surgery · 2026Pooled it
- Enteral nutrition-related hyperglycemia in critical illness: cascade conceptual model and implications for precision nursing-a systematic review.Frontiers in nutrition · 2026Pooled it
- Intensive vs. conventional insulin therapy in neurosurgical patients: a meta-analysis of postoperative infections and hypoglycemic risks.Neurosurgical review · 2025Pooled it
- Sex and gender considerations in randomized controlled trials in critical care nephrology: a meta-epidemiologic study.BMC medicine · 2025Pooled it
- Effect of liberal glucose control on critically ill patients: a systematic review and meta-analysis.BMC endocrine disorders · 2025Pooled it
- Biologic Mechanisms Underlying the Heterogeneous Response to Tight Glycemic Control among Differentially Inflamed Patients in the HALF-PINT Trial.American journal of respiratory and critical care medicine · 2025Trial
- Effect of Remimazolam and Propofol on Blood Glucose and Serum Inflammatory Markers in Patients with Type 2 Diabetes: A Clinical Trial with Prospective Randomized Control.Medicina (Kaunas, Lithuania) · 2025Trial
- Randomized Study Comparing Continuous Glucose Monitoring and Capillary Glucose Testing in Patients With Type 2 Diabetes After Hospital Discharge.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2025Trial
- Individualising blood glucose control in ICU patients: evidence and practical implementations.Critical care (London, England) · 2026Review
- Hypoxia-inducible factor-1: A new neuroprotective agent for the treatment of hyperglycemia after stroke.Neural regeneration research · 2026Article
- Association between stress hyperglycemia ratio and 72-hour delirium in critically ill patients: A retrospective cohort study from the MIMIC-IV database.Metabolism open · 2026Article
- Electrophysiology of Neuromuscular Disorders in Critical Illness.Muscle & nerve · 2026Review
- Subcutaneous glucose tracking during extreme perioperative perfusion stress: a prospective microdialysis study.Journal of clinical monitoring and computing · 2026Article
- Gaps or paradoxes in clinical responses in obese patients.Intensive care medicine · 2026Article
- Postoperative hyperglycemia, nutritional recovery, and diabetes duration as predictors of complications after colorectal cancer surgery.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Glycemic Control in Severe Acute Brain Injury: Systematic Review and Meta-analysis with Trial Sequential Analysis.Neurocritical care · 2026Review
- Multidimensional Classification of Insulin Resistance (MCIR) Focused on Therapeutic Targets and Interventions-A Comprehensive Review.International journal of molecular sciences · 2026Review
- Correlation between SHR and 28-day all-cause mortality risk in patients with spontaneous intracerebral hemorrhage.BMC neurology · 2026Article
2,095 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyperglycemia and insulin resistance are common in critically ill patients, even if they have not previously had diabetes. Whether the normalization of blood glucose levels with insulin therapy improves the prognosis for such patients is not known.
methodsWe performed a prospective, randomized, controlled study involving adults admitted to our surgical intensive care unit who were receiving mechanical ventilation. On admission, patients were randomly assigned to receive intensive insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg per deciliter [4.4 and 6.1 mmol per liter]) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg per deciliter [11.9 mmol per liter] and maintenance of glucose at a level between 180 and 200 mg per deciliter [10.0 and 11.1 mmol per liter]).
resultsAt 12 months, with a total of 1548 patients enrolled, intensive insulin therapy reduced mortality during intensive care from 8.0 percent with conventional treatment to 4.6 percent (P<0.04, with adjustment for sequential analyses). The benefit of intensive insulin therapy was attributable to its effect on mortality among patients who remained in the intensive care unit for more than five days (20.2 percent with conventional treatment, as compared with 10.6 percent with intensive insulin therapy, P=0.005). The greatest reduction in mortality involved deaths due to multiple-organ failure with a proven septic focus. Intensive insulin therapy also reduced overall in-hospital mortality by 34 percent, bloodstream infections by 46 percent, acute renal failure requiring dialysis or hemofiltration by 41 percent, the median number of red-cell transfusions by 50 percent, and critical-illness polyneuropathy by 44 percent, and patients receiving intensive therapy were less likely to require prolonged mechanical ventilation and intensive care.
conclusionsIntensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.