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 The last decades have witnessed great changes in the definition of glycemic control in the ICU. In the 1990s, stringent glucose control was encouraged. However, later studies have reported the complications of hypoglycemia.

 After the NICE‐SUGAR trial demonstrated increased mortality with intensive control, current guidelines recommend a more lenient approach with a target blood glucose level of approximately 140–180 mg/dL. The prevalence of diabetes in the USA has greatly increased to an astonishing 23.9% of the population, 40% of whom are still undiagnosed. The prevalence of diabetes in hospitalized patients appears to be as high as 25%. However, because inpatient diabetes studies are not routinely performed this number is likely underestimated. It is estimated that about 3160 dollars per patient are saved in health care costs as a result of decreased ICU length of stay, sepsis, renal failure, and even mechanical ventilation.

 The causes of hyperglycemia in the ICU are complex and not limited to diabetes but are also caused by the impact of stress hormones such as cortisol including both stress‐induced or iatrogenic increases in steroid levels. Differentiation between the causes of hyperglycemia is challenging which is why the exact incidence of each is not yet known.