Anthony Colpo,
January 26, 2005.

When treating intensive care unit patients, conventional medical protocols recommend using insulin therapy only when blood glucose levels exceed 12 mmol/l. However, strict maintenance of blood glucose levels of less than 6.1 mmol/l with intensive insulin therapy has shown to reduce intensive care mortality, acute renal failure, critical illness polyneuropathy, and bloodstream infections in critically ill patients by about 40%.

To gain further insight into the possible mechanisms behind these benefits, 363 patients requiring intensive care for more than 7 days were randomly assigned to either conventional or intensive insulin therapy.

Intensive insulin therapy effectively normalized blood glucose levels within 24 hours, both in survivors and non-survivors. Intensive insulin therapy also increased serum levels of LDL, decreased the decline in HDL levels, and suppressed elevated blood triglycerides.

After adjustment for multiple confounders, the researchers found that it was the increase in lipids rather than the decrease in blood glucose that was most strongly correlated with the beneficial effects of intensive insulin therapy on morbidity and mortality.

The researchers speculated that the benefits of higher cholesterol in critically ill patients could be due to protection against infectious agents by LDL and HDL, or from LDL's role as a transporter for cholesterol which is essential for the integrity of cell membranes.

Reference