Severe and minor hypoglycemia occurred 86 and 41% more often with intensive glycemic treatment.
Hospitalization occurred 7% more often with intensive treatment, in 2,146 vs. 2,039 individuals, leading to 5,645 vs. 5,039 total hospitalizations.
A recent systematic review suggests that patients who are perceived not to benefit from critical care are more often refused intensive care unit admission [ 27].
Severe and nonsevere hypoglycemia did occur more often with intensive glycemic treatment in ADVANCE, although the investigators did not report this to be associated with any less benefit of the intervention.
During the index admission, patients experiencing an AE were more often admitted to intensive care or intermediate care (45.5 %) compared to those without an AE (21.0 %).
Severe hypoglycemic episodes those requiring assistance of another individual to avoid or respond to seizure or coma occurred three times more often in the intensive therapy group.
Non-survivors were older, acquired infection more often in the intensive care unit, had a higher SAPS II after randomization, more disease-related events (except for mental deterioration) and required more and higher vasopressor dosages than survivors.
The VADT similarly reported that hypoglycemia occurred more often in association with intensive glycemic treatment and was associated with adverse outcome.
These patients were also more often treated in an intensive care ward (n = 44/81 versus n = 24/69, chi-square, p = 0.02) and more often received respirator treatment (n = 36/81 versus 19/69, p = 0.03).
