Intensive Insulin Therapy Trialists' Collaboration (IIT-TC)

Hyperglycaemia is a common finding in patients who are acutely ill even in the absence of a prior diagnosis of diabetes mellitus. In acutely ill patients, hyperglycaemia is associated with a worse outcome.

As hyperglycaemia is consistently associated with increased morbidity and mortality, critical care researchers have conducted a number of trials to investigate whether tighter control of blood glucose in critically ill patients is beneficial. To date there have been over 30 randomised controlled trials of tight glucose control in critical care settings.

However, many studies have reported non-significant results; in part this is because many of the trials were small and when considered alone had insufficient statistical power to examine the effects of tight glucose control on mortality.

Aims

The aim of this collaborative research project is to combine the individual patient data from all randomized controlled trials of tight glucose control in critically ill adults around the world to conduct individual patient meta-analysis to provide the most robust and reliable evidence possible to identify the factors, at patient, hospital or trial level, that influence whether targeting a blood glucose concentration of ≤6.6 mmol/L (≤120 mg/dL) generated outcome benefit or harm, as compared to a higher blood glucose target (either intermediate or high glucose target in control group).

Design

Meta-analysis using individual patient data collected in randomized controlled trials of tight glucose control in critically ill adults worldwide.

Status

Individual patient data on identified common variables have been collected from international collaborators. Data analysis has completed. Manuscript now is in preparation.