Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.


Simon Finfer, George Institute for Global Health, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney
Jan Wernerman, Department of Anestesiology and Intensive Care Medicine, Karolinska University Hospital, Solnavägen 1
Jean-Charles Preiser, Department of Intensive Care, Erasme University Hospital
Tony Cass, Institute of Biomedical Engineering, Imperial College, South Kensington Campus, Exhibition Rd., London
Thomas Desaive, GIGA - Cardiovascular Sciences, University of Liege, Institute of Physics
Roman Hovorka, Institute of Metabolic Science, University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital
Jeffrey I Joseph, Jefferson Artificial Pancreas Center and Anesthesiology Program for Translational Research, Department of Anesthesiology, Jefferson Medical College of Thomas Jefferson UniversityFollow
Mikhail Kosiborod, Saint-Luke's Mid America Heart Institute, University of Missouri - Kansas City
James Krinsley, Division of Critical Care, Stamford Hospital, Columbia University College of Physicians and Surgeons
Iain Mackenzie, Department of Anaesthesia and Intensive Care Medicine, Queen Elizabeth Hospital Birmingham, Queen Elizabeth Medical Centre
Dieter Mesotten, Department of Intensive Care Medicine, University Hospitals Leuven
Marcus J Schultz, Department of Intensive Care Medicine, Academic Medical Center at the University of Amsterdam
Mitchell G Scott, Department of Pathology and Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine
Robbert Slingerland, Isala Klinieken, Department of Clinical Chemistry
Greet Van den Berghe, Department of Intensive Care Medicine, University Hospitals Leuven
Tom Van Herpe, Department of Intensive Care Medicine, University Hospitals Leuven; Department of Electrical Engineering (ESAT-SCD), Katholieke Universiteit Leuven

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This article has been peer reviewed and is published in Critical Care.

Volume 17, Issue 3, 14 June 2013, Article number229

The published version is available at DOI: 10.1186/cc12537. © 2013 BioMed Central Ltd.


The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting.

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