ALLERGY, RESPIRATORY
Asthmatics Who Quit Smoking May Reverse Lung Damage
Know Your Asthma Triggers
Using Music and Sports to Improve Kids' Asthma
ALTERNATIVE MEDICINE
Holistic Treatment for Candida Infection
Needling Away Your Headaches With Acupuncture
Acupuncture May Ease Depression During Pregnancy
ANIMAL CARE
Safe Toys for Dogs
Animals Respond to Acupuncture's Healing Touch
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Tai Chi May Help Ease Fibromyalgia
Using a Balloon to Repair a Broken Back
Rheumatoid Arthritis a Threat to the Heart
CANCER
Want to Stop Cancer? You Can, Experts Say
Antioxidants Pose No Melanoma Threat
Massage Therapy Helps Those With Advanced Cancer
CAREGIVING
Mild Flu Season Coming to a Close
Stressed Health Care Workers Battle 'Compassion Fatigue'
Falls Are Top Cause of Injury, Death Among Elderly
CIRCULATORY SYSTEM
Common Antioxidant Might Slow Parkinson's
Anemia Rates Down for U.S. Women and Children
Exercise Extends Life of Kidney Patients
COSMETIC
Health Tip: After Liposuction
Wrinkle Fillers Need Better Label Warnings: FDA Panel
What to Do If You Have Unsightly Veins
DENTAL, ORAL
Scientists Find Gene for Tooth Enamel
Acupuncture May Ease Anxiety Over Dental Work
Gum Disease May Reactivate AIDS Virus
DIABETES
Fish Twice a Week Cuts Diabetics' Kidney Risks
Formula Puts Doctor, Patient Glucose Readings on Same Page
Brown Rice Bests White for Diabetes Prevention
DIET, NUTRITION
Heart Disease May Be Prevented By Taking Fish Oils, Study Shows
An Apple a Day May Help Keep Heart Disease Away
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Exposure to 9/11 Fumes Tied to Chronic Headaches
Greenhouse Gases Hazardous to Your Health
Controversial Chemical Lingers Longer in the Body
EYE CARE, VISION
Brain Pressure More Likely to Cause Vision Loss in Men
Diabetic Eye Disease Rates Soaring
Time Teaches Brain to Recognize Objects
FITNESS
When It Comes to Lifting, the Pros Have Your Back
Living With Less TV, More Sweat Boosts Weight Loss
Want to Stop Cancer? You Can, Experts Say
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Japanese Herbals May Ease Gastro Woes
Intestinal Bacteria Trigger Immune Response
GENERAL HEALTH
Have Fun This Summer, But DO Be Careful
Hand-Washing Habits Still Need Improvement: Survey Says
Diet, Exercise May Slow Kidney Disease Progression
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Study Suggests Link Between Cell Phones and Brain Tumors
Subway Defibrillators Save Lives
'Cell Phone Elbow' -- A New Ill for the Wired Age
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Omega-3, Some Omega-6 Fatty Acids Boost Cardiovascular Health
A Little Chocolate May Do the Heart Good
Women Who Run May Benefit From Extra Folic Acid
INFECTIOUS DISEASE
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
Viral Infection Might Trigger High Blood Pressure
Poor Restroom Cleaning Causes Cruise-Ship Sickness
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
St. John's Wort Doesn't Work for ADHD
Treat Kids to a Safe Halloween
Green Tea May Help Brain Cope With Sleep Disorders
MEN'S HEALTH
Varicose Veins May Mask Larger Problem
Could Chinese Herb Be a Natural Viagra?
Sunlight May Help Protect Men From Kidney Cancer
MENTAL HEALTH
Man's Best Friend Helps Mend Broken Hearts
Bullying Seems to Affect Kids Years Later
Heal Your Life Tips for Living Well
PAIN
'Cell Phone Elbow' -- A New Ill for the Wired Age
Are We Exercising Pain Away? Not So Much.
Tai Chi May Help Ease Fibromyalgia
PHYSICAL THERAPY
PREGNANCY
Sugary Colas Tied to Gestational Diabetes
Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
Acupuncture May Ease Depression During Pregnancy
SENIORS
Want Better Health in the New Year, Add Exercise to Your Day
Healthy Diet Could Cut Alzheimer's Disease Risk
The Juice From Beetroots May Boost Stamina
SEXUAL HEALTH
SLEEP DISORDERS
6 to 8 Hours of Shut-Eye Is Optimal for Health
Moderate Aerobics May Ease Insomnia Symptoms
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Most Women With Osteoporosis Unaware of Raised Fracture Risk
Prenatal Stress May Boost Baby's Asthma Risk
Iodine in Prenatal Vitamins Varies Widely
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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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