{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:50:44Z","timestamp":1791525044427,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2021JJ30040"],"award-info":[{"award-number":["2021JJ30040"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3601900"],"award-info":[{"award-number":["2022YFC3601900"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2505500"],"award-info":[{"award-number":["2022YFC2505500"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011790","name":"Xiangya Hospital, Central South University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011790","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002822","name":"Central South University","doi-asserted-by":"publisher","award":["2021KFJJ06"],"award-info":[{"award-number":["2021KFJJ06"]}],"id":[{"id":"10.13039\/501100002822","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672225"],"award-info":[{"award-number":["81672225"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal glucose targets for critically ill patients are likely to vary by underlying condition, yet a \u2018one\u2010size\u2010fits\u2010all\u2019 approach persists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Determining disease\u2010specific glucose thresholds may help achieve the lowest mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This study combined a retrospective cohort analysis of the Medical Information Mart for Intensive Care\u2010IV (MIMIC\u2010IV) database with a frequentist network meta\u2010analysis (NMA) of randomized controlled trials (RCTs). The glucose control targets, measured by time\u2010weighted average glucose (TWAg), were categorized into four strata: strict, intermediate strict, liberal and very liberal control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The retrospective analysis included 21\u2009119 sepsis, 16\u2009957 cardiac and 4708 neurological patients. In both sepsis and cardiac patients, compared with the intermediate strict control group (110\u2013150\u2009mg\/dL, reference), both the strict (80\u2013110\u2009mg\/dL: HR 1.10\/1.26, both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and liberal (150\u2013180\u2009mg\/dL: HR 1.38\/1.78, both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) control groups showed significantly higher 28\u2010day mortality. In contrast, among neurological patients, strict control conferred a survival benefit (HR 0.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). The NMA of 35 RCTs corroborated these findings for sepsis and neurological disorders, with intermediate strict control ranking highest for sepsis (P\u2010score 74.9%) and strict control highest for neurological disorders (P\u2010score 71.2%), whereas liberal control ranked highest for cardiac disease (P\u2010score 83.5%); no pairwise differences were statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study provides evidence that optimal glucose targets in the ICU are disease\u2010specific. In the retrospective analysis, intermediate strict control was associated with the lowest mortality in sepsis and cardiac disease, while strict control may benefit neurological patients without excess hypoglycaemia. However, for cardiac disease, the NMA ranked liberal control highest, leaving the optimal target uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>These findings may support a pathophysiology\u2010guided, individualized approach to glycaemic management in critically ill patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70731","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:36:51Z","timestamp":1791459411000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease\u2010Specific Optimal Blood Glucose Control Strategies in Critically Ill Patients: Retrospective Cohort Study and Network Meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Xinyao","family":"He","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Xiangya Hospital, Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0511-3365","authenticated-orcid":false,"given":"Jiahao","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xiangya Hospital, Central South University  Changsha China"},{"name":"Key Laboratory of Aging\u2010Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4968-1789","authenticated-orcid":false,"given":"Yiqun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center of Respiratory Medicine, Xiangya Hospital Central South University  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingui","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Affiliated Chenzhou Hospital (The First People's Hospital of Chenzhou) University of South China  Chenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1135-7876","authenticated-orcid":false,"given":"Shuguang","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Xiangya Hospital, Central South University  Changsha China"},{"name":"Key Laboratory of Aging\u2010Related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital Central South University  Changsha China"},{"name":"National Clinical Research Center for Geriatric Diseases, Xiangya Hospital of Central South University  Changsha China"},{"name":"Department of Sports Medicine, Xiangya Hospital Central South University  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