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Glucontrol Study: Comparing the Effects of Two Glucose Control Regimens by Insulin in Intensive Care Unit Patients

Not Applicable
Completed
Conditions
Critical Illness
Registration Number
NCT00107601
Lead Sponsor
University of Liege
Brief Summary

Glucontrol is a prospective, randomized, controlled, multi-centric study. The present study will compare the effects of two regimens of insulin therapy, respectively titrated to achieve a blood sugar level between 4.4 and 6.1 mmol/l (80 and 110 mg/dl, respectively) and between 7.8 and 10.0 mmol/l (140 and 180 mg/dl, respectively).

This project aims at defining whether a tight glucose control by insulin improves the vital outcome in a mixed population of critically ill patients (around 3000 patients).

Secondary outcome variables will include in-hospital and 28-day mortality, lengths of stays in the Intensive Care Unit (ICU) and in the hospital, length of ICU stay without life-support therapy, number and clinical signs of episodes of hypoglycemia, rates of infections and organ failures, and number of red-cell transfusions.

Detailed Description

Hyperglycemia frequently occurs during critical illness and is commonly implicated in the development of potentially lethal infectious, vascular and metabolic complications. We hypothesize that a control of glycemia by insulin will improve the vital outcome and the rate of complications in a heterogeneous population of critically ill patients. This hypothesis is supported by the findings of a recent trial performed in one surgical intensive care unit, which demonstrated a significant improvement in vital outcome and in several indices of morbidity in patients randomized to a tight control of glycemia. However, these findings can hardly be extrapolated to other conditions, including different types of pathologies and management. The present prospective, randomized, controlled and multicentric study, will compare the effects of two regimens of insulin therapy, respectively titrated to achieve a blood sugar level between 4.4 and 6.1 mmol/l (80 and 110 mg/dl, respectively) and between 7.8 and 10.0 mmol/l (140 and 180 mg/dl, respectively) and will be powered to detect a 4% decrease in absolute intensive care unit (ICU) mortality. Secondary outcome variables will include in-hospital and 28-day mortality, lengths of stays in ICU and in the hospital, length of ICU stay without life-support therapy, number and clinical signs of episodes of hypoglycemia, rates of infections and organ failures, number of red-cell transfusions.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3500
Inclusion Criteria
  • All adult (older than 18 years old at admission) patients admitted in Intensive Care Unit whatever the reason
Exclusion Criteria
  • Absence of the informed consent (as approved by the local ethical committee).
  • Life expectancy lower than 24 hours, as estimated upon admission.
  • Therapeutic limitation upon admission in ICU
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Mortality in the Intensive Care Unit (ICU)
Secondary Outcome Measures
NameTimeMethod
Hospital mortality
28 Day mortality
Length of ICU stay
Length of hospital stay
Number of episodes of hypoglycemia and associated clinical signs
Infectious morbidity
Incidence of organ failures
Number of red-cell transfusions
Number of days spent in ICU without life-support: vasopressors/inotropes, cardiac mechanical support, mechanical ventilation, renal replacement therapy
Daily SOFA (Sequential Organ Failure Assessment) Score

Trial Locations

Locations (11)

V.U.Z. Amsterdam

🇳🇱

Amsterdam, Netherlands

C.H.U. Vaudois

🇨🇭

Lausanne, Switzerland

Hospital Universitario General Negrin

🇪🇸

Las Palmas de Gran Canaria, Spain

Hopital Raymond Poincare

🇫🇷

Garches, France

University Hospital Gasthuisberg

🇧🇪

Leuven, Belgium

Centre Hospitalier Universitaire de Liège

🇧🇪

Liege, Belgium

Université Joseph Fournier

🇫🇷

Grenoble, France

Rabin Medical Center

🇮🇱

Patah Tiqwa, Israel

Universität Ulm

🇩🇪

Ulm, Germany

Institut Gustave Roussy

🇫🇷

Villejuif, France

C.H.U. Erasme

🇧🇪

Bruxelles, Belgium

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