Until the end of the past millenium, relatively little attention was given to control of blood sugar levels. In critically ill patients, hyperglycaemia was considered to be physiological because it results from the metabolic and hormonal changes that accompany the stress response to injury. In most intensive care units (ICUs), blood sugar was checked every 4–6 hours and hyperglycaemia (defined as blood sugar levels >10–12 mmol/l [180–216 mg/dl]) was corrected by subcutaneous or intravenous insulin. The presence of pre-existing diabetes mellitus or post-neurosurgical status often prompted more intense control of hyperglycaemia. Furthermore, the issue of glucose control was discussed in few sessions or satellite symposia during intensive care meetings. 1 1 2 post hoc  3 4 5 1 6 Critical Care  7 2 4 5 8 Abbreviation ICU = intensive care unit. Competing interests The author(s) declare that they have no competing interests.