Society of Critical Care Medicine Guidelines on Glycemic Control for Critically Ill Children and Adults 2024
Based on available randomized controlled trial data, in critically ill adults, we “suggest against” titrating an insulin infusion to a lower BG target INT: 4.4–7.7 mmol/L (80–139 mg/dL) as compared with a higher BG target range, CONV: 7.8–11.1 mmol/L (140–200 mg/dL) to reduce the risk of hypoglycemia (Conditional recommendation; moderate certainty of evidence). Observational data suggest a potential benefit of personalized glucose targets that more closely match chronic prehospital glycemic control. We recommend high-quality interventional trials of individualized glycemic targets in critically ill adults, stratified by prior glycemic control (such as indicated by glycosylated hemoglobin) (research statement).
2012 Statement
In adult critically ill patients, we suggest that a BG ≥ 150 mg/dL should trigger initiation of insulin therapy, titrated to keep BG < 150 mg/dL for most adult ICU patients and to maintain BG values absolutely <180 mg/dL using a protocol that achieves a low rate of hypoglycemia (BG ≤ 70 mg/dL) despite limited impact on patient mortality. (Quality of evidence: very low).
Society of Critical Care Medicine Guidelines on Glycemic Con... : Critical Care Medicine (lww.com)