Trial reportNeurocritical care2010
Intensive versus conventional insulin therapy in critically ill neurologic patients.
Trial report in Neurocritical care, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 7 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Intensive vs. conventional insulin therapy in neurosurgical patients: a meta-analysis of postoperative infections and hypoglycemic risks.Neurosurgical review · 2025Pooled it
- Is intensive glucose control bad for critically ill patients? A systematic review and meta-analysis.International journal of biological sciences · 2020Pooled it
- Pooled it
- Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis.Critical care (London, England) · 2018Pooled it
- Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials.Intensive care medicine · 2017Pooled it
- Insulin for glycaemic control in acute ischaemic stroke.The Cochrane database of systematic reviews · 2014Pooled it
- Optimal glycemic control in neurocritical care patients: a systematic review and meta-analysis.Critical care (London, England) · 2012Pooled it
- Effects of tight computerized glucose control on neurological outcome in severely brain injured patients: a multicenter sub-group analysis of the randomized-controlled open-label CGAO-REA study.Critical care (London, England) · 2014Trial
- Glycemic Control in Severe Acute Brain Injury: Systematic Review and Meta-analysis with Trial Sequential Analysis.Neurocritical care · 2026Review
- Effect of glucose on functional outcome and case-fatality in patients with spontaneous intracerebral hemorrhage.BMC neurology · 2026Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- Metabolic derangements are associated with impaired glucose delivery following traumatic brain injury.Brain : a journal of neurology · 2021Observational
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).Journal of intensive care · 2021Article
- Clinical predictors of prognosis in patients with traumatic brain injury combined with extracranial trauma.International journal of medical sciences · 2021Article
- Updates in Glycemic Management in the Hospital.Current diabetes reports · 2019Review
- Intensive glucose control for critically ill patients: an updated meta-analysis.Endocrine connections · 2018Article
- Effect of intensive glycaemic control on moderate hypoglycaemia and ICU length of stay in severe traumatic brain injury.Critical care (London, England) · 2018Article
- European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke.European stroke journal · 2018Article
- Continuous glucose monitoring in the ICU: clinical considerations and consensus.Critical care (London, England) · 2017Review
- The optimal target for acute glycemic control in critically ill patients: a network meta-analysis.Intensive care medicine · 2017Review
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies of glycemic control in non-neurologic ICU patients have shown conflicting results. The purpose was to investigate whether intensive insulin therapy (IIT) to keep blood glucose levels from 80 to 110 mg/dl or conventional treatment to keep levels less than 151 mg/dl was associated with a reduction of mortality and improved functional outcome in critically ill neurologic patients.
methodsWithin 24 h of ICU admission, mechanically ventilated adult neurologic patients were enrolled after written informed consent and randomized to intensive or conventional control of blood glucose levels with insulin. Primary outcome measure was death within 3 months. Secondary outcome measures included 90-day modified Rankin scale (mRS) score, ICU, and hospital LOS.
results81 patients were enrolled. The proportion of deaths was higher among IIT patients but this was not statistically significant (36 vs. 25%, P = 0.34). When good versus poor outcome at 3 months was dichotomized to mRS score 0-2 versus 3-6, respectively, there was no difference in outcome between the two groups (76.2 vs. 75% had a poor 3-month outcome, P = 1.0). There was also no difference in ICU or hospital LOS. Hypoglycemia (<60 mg/dl) and severe hypoglycemia (<40 mg/dl) were more common in the intensive arm (48 vs. 11%, P = 0.0006; and 4 vs. 0%, P = 0.5, respectively).
conclusionThere was no benefit to IIT in this small critically ill neurologic population. This is the first glycemic control study to specifically examine both critically ill stroke and traumatic brain injury (TBI) patients and functional outcome. Given these results, IIT cannot be recommended over conventional control.
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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.