How does blood glucose control with insulin save lives in intensive care?

J Clin Invest. 2004 Nov;114(9):1187-95. doi: 10.1172/JCI23506.


Patients requiring prolonged intensive care are at high risk for multiple organ failure and death. Insulin resistance and hyperglycemia accompany critical illness, and the severity of this "diabetes of stress" reflects the risk of death. Recently it was shown that preventing hyperglycemia with insulin substantially improves outcome of critical illness. This article examines some potential mechanisms underlying prevention of glucose toxicity as well as the effects of insulin independent of glucose control. Unraveling the molecular mechanisms will provide new insights into the pathogenesis of multiple organ failure and open avenues for novel therapeutic strategies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Critical Care
  • Critical Illness
  • Glucose / toxicity
  • Humans
  • Hyperglycemia / pathology
  • Hypoglycemic Agents / therapeutic use
  • Insulin / metabolism*
  • Insulin Resistance
  • Models, Biological
  • Time Factors


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Glucose