ICU Glucose Target NICE-SUGAR — FRCA Final MCQ

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ModerateIntensive Care MedicineICU Glucose Target NICE-SUGARFRCA Final

A 50-year-old man in the ICU has been on mechanical ventilation for 10 days. He has a glucose of 12.5 mmol/L. According to NICE-SUGAR trial evidence, what is the target blood glucose range for critically ill patients?

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Correct answer: D — 6.0-10.0 mmol/L

The NICE-SUGAR trial (2009) demonstrated that intensive glucose control (4.5-6.0 mmol/L) in critically ill patients increased mortality compared to conventional control (≤10.0 mmol/L). This landmark trial reversed previous practice based on the Leuven study. Current SSC guidelines (2021) and ICS standards recommend targeting blood glucose ≤10.0 mmol/L (typically 6-10 mmol/L range), using insulin infusion when glucose exceeds 10 mmol/L, and avoiding hypoglycaemia (<4.0 mmol/L) which independently increases mortality.

Reference: NICE-SUGAR Investigators – 2009 – NEJM; SSC – 2021 – International guidelines; ICS – 2023 – ICU nutrition