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The following is a summary of “Comparison of all-cause mortality with different blood glucose control strategies in patients with diabetes in the ICU: a network meta-analysis of randomized controlled trials,” published in the April 2025 issue of Annals of Intensive Care by Li et al. 

Researchers conducted a retrospective study to compare the effects of strict, intermediate, strict, liberal, and very liberal glucose control on all-cause mortality in individuals with diabetes in the intensive care unit (ICU) through a network meta-analysis.  

They searched PubMed, Cochrane Library, Embase, and Web of Science for randomized controlled trials (RCTs) comparing glucose control strategies in individuals with diabetes in the ICU up to October 1, 2024. The primary outcome was all-cause 90-day mortality. The Risk of Bias 2 tool assessed study bias. Data analysis was performed using Stata (version 17).  

The results showed that 12 RCTs with 5,297 participants were analyzed. No statistically significant difference was found among the 4 glucose control strategies in reducing all-cause 90-day mortality. The surface under the cumulative ranking (SUCRA) indicated the highest probability for intermediate strict control (SUCRA 88%), followed by liberal control (SUCRA 55.3%), very liberal control (SUCRA 40.3%), and strict control (SUCRA 16.5%). The most probable ranking for reducing all-cause mortality, from best to worst, was intermediate strict control, liberal control, very liberal control, and strict control.  

Investigators concluded that in ICU patients with diabetes, no glucose control strategy demonstrated a statistically significant reduction in 90-day all-cause mortality and the SUCRA rankings were hypothesis-generating. 

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-025-01471-x