Aggressively Controlling Blood Sugar Levels May Be Killing ICU Patients, Researchers Say

Aggressively lowering glycemia, or high blood sugar, in people who are being treated in hospital intensive care units may be killing some patients, new research shows.

People who become acutely ill and also have high blood sugar levels tend to do worse than others, but now the common practice of using medication to dramatically lower blood sugar in urgently hospitalized people in an effort to improve their treatment has been linked to problems.

Medicating patients to bring down their blood sugar levels may increase the overall death rate by as much as 10 percent, according to the researchers.

Study Finds Risks of Lowering Blood Sugar

Researchers examined 6,104 patients in the United States, Australia, Canada, and New Zealand, including 20 percent who had a history of diabetes. It is the largest such study to look at high blood sugar in acutely ill patients, officials said. Results of the study were published in the New England Journal of Medicine.

The study found that hospitalized patients who were treated more aggressively with intravenous insulin to lower blood sugar levels fared worse than other patients who were not subjected to as aggressive treatment. Ninety days after being admitted into intensive care, 27.5 percent of patients whose sugar levels were kept below 108 milligrams per deciliter of blood had died, compared to 24.9 percent whose sugar levels were kept under 180.

Also, the group with lower glucose controls suffered more fatal heart attacks and nearly seven percent of patients receiving aggressive treatment developed dangerously low blood sugar levels, compared to just 0.5 percent in the less aggressive group, the researchers said.

Other Studies Detail Similar Problems

In 2008, a study called ACCORD found that lowering already normal blood sugar levels in patients with adult-onset diabetics who were facing a high risk of heart disease did not prevent heart attacks and strokes. To the contrary, the research found that those patients whose normal blood sugar levels were lowered were more likely to suffer a fatal heart attack.

The practice of lowering blood sugar levels is commonly regarded as good medicine and effective at reducing the risks of kidney disease, blindness, and other severe complications associated with diabetes. But with the recent medical research studies finding a link between increased patient deaths and aggressively lowering blood-sugar levels, many physicians are beginning to reexamine the way they handle glycemia in acutely ill patients.

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