Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match thenthereby their performance to fit the needs of patients and clinicians in the intensive care setting.See related commentary by Soto-Rivera and Agus, http://ccforum.com/content/17/3/155BackgroundIn 2001 Van den Berghe and colleagues reported that targeting a blood glucose concentration of 4.4 to 6.1 mmol/l (80 to 110 mg/dl) in adult patients treated in a surgical ICU reduced both morbidity and mortality [1]. This research had a profound effect on the way the management of blood glucose in critically ill patients was perceived, with widespread recognition that blood glucose management could affect important patient outcomes.

Van den Berghe and colleagues’ paper led to a large body of research from numerous investigators that produced a much better understanding of the issues surrounding the control of blood glucose, also highlighting areas where additional research and agreement are urgently needed.Completed and ongoing research has highlighted two critically important issues that currently hamper our understanding of the best approach to glycemic control in critically ill patients. The first relates to how blood glucose concentration is measured, because inaccurate blood glucose measurement adversely effects glycemic control and may result in direct harm to patients. The second issue relates to how glycemic control is reported – currently this is not standardized, which makes comparing the results of much clinical research impossible [2-5].

In Van den Berghe and colleagues’ original trial, blood glucose concentration was measured using a blood gas analyzer, a method that has been shown to be accurate [2]. Subsequent trials have used a variety of methods to measure the blood glucose concentration, Anacetrapib which have included single specified bedside glucose meters [6,7] or combined methods using specified or unspecified glucose meters and blood gas analyzers variably both within and between sites in multicenter trials [8,9].