Abstract
The optimum solution of tight glycemic control (TGC) in critically ill patients has not been clarified yet. In 2001, the first Leuven study showed the breakthrough outcomes of intensive insulin therapy (IIT) for adult critically ill patients, but none could demonstrate the efficiency of IIT despite having implemented a series of replication researches. The root causes are considered to having been the inevitable uncertainty of protocol-driven glycemic control with the idiosyncratic nutrition management (overfeeding) inherent in the first Leuven study but not the theoretical flaw of IIT. The academic debates over the pros and cons of IIT eventually uncovered the harmful effects of early full feeding under critical illnesses, leading to an innovative change of the nutritional guidelines as well. Now that computer-guided glycemic control is easily feasible with promoting rationalization of nutrition administration, we can open a new chapter toward unveiling the optimal TGC.
