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Published on: April 6, 2022
Glucose variability measures and their effect on mortality: a systematic review.
Saeid Eslami1, Zhila Taherzadeh, Marcus J Schultz
1Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. s.eslami@amc.uva.nl
Intensive Care Medicine
|February 1, 2011
Summary
Glucose variability in critically ill patients is linked to mortality, but various measurement methods and potential biases complicate definitive conclusions. Further research needs standardized metrics and rigorous methodology.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Biostatistics
Background:
- Glucose variability is increasingly recognized as a significant factor in critically ill patients.
- Understanding the association between glucose variability and patient outcomes is crucial for improving clinical management.
Purpose of the Study:
- To systematically review the existing medical literature on the association between glucose variability measures and mortality in critically ill adult patients.
Main Methods:
- A comprehensive search of Ovid MEDLINE and Ovid EMBASE was conducted for relevant clinical trials and observational studies.
- Data extraction focused on patient demographics, study design, glucose control strategies, statistical methods, and specific glucose variability indicators used.
Main Results:
- Twelve studies met the inclusion criteria, utilizing 13 distinct glucose variability indicators.
- Standard deviation and the occurrence of both hypoglycemia and hyperglycemia were the most frequently employed measures.
- All included studies reported a statistically significant association between at least one glucose variability indicator and mortality.
Conclusions:
- While numerous methods exist to quantify glucose variability, each has shown a link to mortality in studies.
- Methodological limitations and potential reporting bias necessitate caution in interpreting these findings.
- Future research should prioritize standardized, physiologically relevant glucose variability metrics with enhanced methodological rigor and transparent reporting.
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