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Available online /content/13/3/143 Commentary NICE-SUGAR: the end of a sweet dream? Jean-Charles Preiser Department of Intensive Care, Centre Hospitalier Universitaire du Sart Tilman, 4000 Liege, Belgium. Corresponding author: Jean-Charles Preiser, Jean-Charles.Preiser@chu.ulg.ac.be Published: 14 May 2009 Critical Care 2009, 13:143 (doi:10.1186/cc7790) This article is online at /content/13/3/143 © 2009 BioMed Central Ltd Abstract concluded simply that tight glucose control is not associated The results of the NICE-SUGAR (Normoglycaemia in Intensive with significantly reduced hospital mortality. Criticisms of Care Evaluation Survival Using Glucose Algorithm Regulation) trial each of the individual studies were raised, including inade- were released last March. The primary outcome variable, 90-day quate statistical power and the use of various degrees of mortality, was actually increased in patients randomly assigned to glucose control, all lower in the subsequent trials [3-7] than in intensive insulin therapy, as compared with an intermediate target the initial Leuven I study [2]. Therefore, the NICE-SUGAR trial range for blood glucose. These findings, reflecting data collected was eagerly awaited by the intensive care medicine in a set of more than 6,000 patients, clearly refute the external validity of tight glucose control. Future research will probably focus community worldwide. on several questions raised by the divergent results repor