Intensive Versus Intermediate Glucose Control in Surgical Intensive Care Unit Patients Featured Article: Takehiro Okabayashi, Yasuo Shima,Tatsuaki Sumiyoshi, Akihito Kozuki, Teppei Tokumaru, Tasuo Iiyama, Takeki Sugimoto, Michiya Kobayashi, Masataka Yokoyama, and Kazuhiro Hanazaki Diabetes Care Volume 37: June, 2014

STUDY OBJECTIVE To determine whether surgical site infection (SSI) is reduced by perioperative intensive insulin therapy (IT) Okabayashi T. et al. Diabetes Care 2014;

STUDY DESIGN AND METHODS Patients were randomly assigned to perioperative intensive IT (target blood glucose of 4.4–6.1 mmol/L) or intermediate IT (target blood glucose 7.7–10.0 mmol/L) in the surgical intensive care unit (ICU) Primary end point defined as the incidence of SSI Okabayashi T. et al. Diabetes Care 2014;

RESULTS Participants were assigned to glucose control with one of two target ranges: 225 patients in the intermediate IT group or 222 patients in the intensive IT group No patients in either group became hypoglycemic Rate of SSI after hepato-biliary-pancreatic surgery was 6.7% Okabayashi T. et al. Diabetes Care 2014;

RESULTS Patients in the intensive IT group had fewer postoperative SSIs and a lower incidence of postoperative pancreatic fistula after pancreatic resection Length of hospitalization in the intensive IT group was significantly shorter than in the intermediate IT group Okabayashi T. et al. Diabetes Care 2014;

CONCLUSIONS Intensive IT decreased the incidence of SSI among patients who underwent hepato-biliary-pancreatic surgery Blood glucose target of 4.4–6.1 mmol/L resulted in a lower rate of SSI than a target of 7.7–10.0 mmol/L Okabayashi T. et al. Diabetes Care 2014;