ALLERGY, RESPIRATORY
Herbal Remedy Could Halt Peanut Allergy
New Spray Could Benefit Cystic Fibrosis Patients
Asthmatics Who Quit Smoking May Reverse Lung Damage
ALTERNATIVE MEDICINE
Meditation, Yoga Might Switch Off Stress Genes
Uncover Why Turmeric Helps You Heal
Could Chinese Herb Be a Natural Viagra?
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Animals Respond to Acupuncture's Healing Touch
Beware of Dog Bites
BONES & JOINTS
Occupational Therapy Plus Exercise Benefits Osteoarthritis
In Elderly Women, Hip Fractures Often Follow Arm Breaks
Pain More a Cause of Arthritis Than a Symptom
CANCER
Broccoli May Help Battle Breast Cancer
Many Cancer Survivors Don't Adopt Healthy Lifestyle
Green Tea Compound Slowed Chronic Lymphocytic Leukemia
CAREGIVING
Timing May Matter in Organ Donation Decisions
With Age Comes Greater Risk of Hypothermia
Weekend Admission May Be Riskier for GI Bleeding
CIRCULATORY SYSTEM
An Apple a Day May Help Keep Heart Disease Away
Bye, Bye Back Fat?
Anemia Rates Down for U.S. Women and Children
COSMETIC
Mouse Study Finds Molecule That Tells Hair to Grow
The Acne Drug Accutane More Than Doubles Depression Risk
Health Tip: After Liposuction
DENTAL, ORAL
Study Links Osteoporosis Drugs to Jaw Trouble
Acupuncture May Ease Anxiety Over Dental Work
Obesity Boosts Gum Disease Risk
DIABETES
Out-of-Control Blood Sugar May Affect Memory
Poor Blood Sugar Control After Heart Surgery Impacts Outcomes
Study Shows Turmeric May Prevent Type 2 Diabetes
DIET, NUTRITION
The Best Diet? That Depends on You
The Food Irradiation Story
School Meals Need to Get Healthier
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Walkable Neighborhoods Keep the Pounds Off
As Earth Warms, Lyme Disease Could Flourish
Heavy Traffic Can Be Heartbreaking
EYE CARE, VISION
Autistic Children Make Limited Eye Contact
Thyroid Problems Boost Glaucoma Risk
When Corks Fly, Watch the Eyes
FITNESS
Bursts of Vigorous Activity Appear to Be a 'Stress-Buffer'
Vigorous Treadmill Workout Curbs Appetite Hormones
'Safe' Ozone Levels May Not Be for Some
GASTROINTESTINAL PROBLEMS
Gum Chewing May Speed Colon Surgery Recovery
Traditional Nonsurgical GERD Treatments Not Impressive
HRT Use Raises Risk of Stomach Trouble
GENERAL HEALTH
Maximize Your Run
Heal Your Life® Tips for Living Well
Swine Flu Is Now a Pandemic Says W.H.O.
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
'Comfort Dogs' Come to Emotional Rescue
The Internet Is Becoming One-Stop Shopping for Health Help
Airport Full Body Scanners Pose No Health Threat: Experts
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Omega-6 Fatty Acids Can Be Good for You
Review Confirms Links Between Diet, Heart Health
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
INFECTIOUS DISEASE
Swine Flu Loves a Crowd
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
Swine Flu Is Now a Pandemic Says W.H.O.
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Standard IQ Test May Underestimate People With Autism
School Meals Need to Get Healthier
Coconut Oil May Help Fight Childhood Pneumonia
MEN'S HEALTH
Whole Grains, Bran May Fight Hypertension in Men
Could Chinese Herb Be a Natural Viagra?
Countdown to Hair Loss
MENTAL HEALTH
Musicians' Brains Tuned to Emotions in Sound
Heal Your Life® Tips for Living Well
Estrogen May Help Men's Hearts
PAIN
'Cell Phone Elbow' -- A New Ill for the Wired Age
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Expectant Mom's Exercise Keeps Newborn's Birth Weight Down
Calcium Supplements Cut Blood Lead Levels During Pregnancy
Music of Mozart Soothes the Preemie Baby
SENIORS
Life Expectancy in U.S. Hits New High
A Little Alcohol May Stave Off Alzheimer's
The Juice From Beetroots May Boost Stamina
SEXUAL HEALTH
SLEEP DISORDERS
Exercising Throat Muscles May Relieve Sleep Apnea
Meditation May Help Put Primary Insomnia to Bed
6 to 8 Hours of Shut-Eye Is Optimal for Health
WOMEN'S HEALTH
Acupuncture May Relieve Acid Indigestation In Pregnancy
Exercise Boosts Bone Density in Breast-Feeding Moms
Omega-3 May Reduce Endometriosis Risk
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Findings Challenge Tight Glucose Control for Critically Ill Patients

TUESDAY, Aug. 26 (HealthDay News) -- Tight glucose control doesn't significantly reduce the risk of in-hospital death among critically ill patients. But, it is associated with an increased risk of hypoglycemia (abnormally low blood sugar), according to a study that challenges the common practice of tight glucose control for this group of patients.

Currently, many major medical organizations advise tight glucose control for critically ill patients, and these recommendations have been adopted in many intensive care units around the world, according to background information in the review study by U.S. researchers.

They analyzed data from 8,432 patients in 29 previous studies and found no significant difference in hospital death rates for patients on tight glucose control (21.6 percent) and those receiving usual care (23.3 percent).

The researchers also found that tight glucose control was not associated with a significantly decreased risk for new need for dialysis (11.2 percent vs. 12.1 percent), but was associated with a significantly decreased risk (10.9 percent vs. 13.4 percent) of septicemia (generalized illness due to bacteria in the blood).

However, patients on tight glucose control had about a five-fold increased risk of hypoglycemia (13.7 percent vs. 2.5 percent).

"Given the overall findings of this meta-analysis, it seems appropriate that the guidelines recommending tight glucose control in all critically ill patients should be re-evaluated until the results of larger, more definitive clinical trials are available," concluded Dr. Renda Soylemez Wiener, of the Department of Veterans Affairs Medical Center in White River Junction, Vt., and Dartmouth Medical School, in Hanover, N.H., and colleagues.

The study was published in the Aug. 27 issue of the Journal of the American Medical Association.

But, Simon Finfer, of the George Institute for International Health, and Anthony Delaney, of the Royal North Shore Hospital in Sydney, Australia, wrote in an accompanying editorial that it's possible that some of the studies included in the meta-analysis were flawed or that the meta-analysis itself was flawed.

"Possible explanations for the discordant results of the study by van den Berghe et al and the meta-analysis by Wiener et al are that the meta-analysis is flawed, the studies that form the basis of the meta-analysis are flawed or inherently different, or the findings of the study by van den Berghe et al occurred due to random chance or as a result of another unique factor interacting with tight glycemic control."

They added that "those investigating tight glycemic control should take a step back and address the fundamental questions of defining quality standards for tight glycemic control, finding affordable methods of frequent and highly accurate measurement of blood glucose in the ICU, and conduct multicenter efficacy studies to determine if tighter glycemic control can reduce mortality under optimal conditions. If tighter glycemic control can be proven effective in optimal conditions, determining how to make that benefit available to millions of critically ill patients in both developed and resource-poor countries around the world would be a truly worthwhile challenge. There is no simple or clear answer to the complex problem of glycemic control in critically ill adults; at present, targeting tight glycemic control cannot be said to be either right or wrong."

More information

The American Thoracic Society has more about critical care.



-- Robert Preidt



SOURCE: Journal of the American Medical Association, news release, Aug. 26, 2008

Last Updated: Aug. 26, 2008

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