Glycaemic control (GC) in the intensive care unit is contentious. Hyperglycaemia, hypoglycaemia, and glycaemic variability are all associated with increased morbidity and mortality. While some studies and physiological evidence suggests GC should benefit hyperglycaemic patients, others show no or negative effects and increased incidence of hypoglycaemia. Interpretation of results is made more difficult by differences in the measurement and reporting of glycaemic control, blood glucose levels and variability in patients. In addition, target ranges for glycaemic control are not universally accepted, and higher targets are often used out of fear of hypoglycaemia, rather than their relationship to a clinical outcome. Importantly, current metrics are mostly mathematically derived, and then related to a potential clinical outcome, yielding highly variable results, while very few are clinically defined first. Thus, the goal metrics for control are not directly clinically defined.

This paper reviews differences in the reporting of BG level and its variability in literature. It then proposes a vision for improved description of glycaemia and presents a continuous glucose monitoring (CGM) sensor-based method to better quantify glycaemic level and variability, based on clinically defined metrics. A case study of this new method is presented using CGM sensor data from a study of 614 infants at risk of neonatal hypoglycaemia. Results show the new clinically defined method is able to describe changes in glycaemic level and variability in these patients and presents a flexible way forward for accurately describing state and variability from a clinically defined perspective. This method may provide better insight to patient glycaemia over time, and thus provide scope for improved control of glycaemia.

重症监护病房的血糖控制（GC）存在争议。高血糖，低血糖和血糖变异性均与发病率和死亡率增加相关。尽管一些研究和生理证据表明，GC应该有益于高血糖患者，但其他研究则显示无副作用或负面影响，并且低血糖发生率增加。由于血糖控制，血糖水平和患者变异性的测量和报告方面的差异，结果的解释变得更加困难。另外，血糖控制的靶标范围未被普遍接受，并且出于担心低血糖症而不是与临床结果之间的关系，经常使用较高的靶标。重要的是，当前指标大多是通过数学推导得出的，然后与潜在的临床结果相关，产生高度可变的结果，而临床上首先定义的很少。因此，控制的目标指标并未直接在临床上定义。

本文回顾了BG水平报告及其文献差异的差异。然后，提出了改善血糖描述的愿景，并提出了一种基于临床监测指标的基于连续葡萄糖监测（CGM）传感器的方法，以更好地量化血糖水平和变异性。这项新方法的案例研究使用CGM传感器数据进行，该数据来自对614名有新生儿低血糖风险的婴儿的研究。结果表明，新的临床定义方法能够描述这些患者的血糖水平和变异性变化，并提出了一种灵活的方法，可以从临床定义的角度准确描述状态和变异性。随着时间的流逝，该方法可以更好地了解患者的血糖，从而为改善血糖控制提供了空间。