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Glycemic variability and outcome in critically ill

Subhash Todi1, Mahuya Bhattacharya1

  • 1Department of Critical Care Medicine, AMRI Hospitals, Kolkata, West Bengal, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|June 11, 2014
PubMed

Insights

High glucose variability (GV) is linked to increased intensive care unit (ICU) mortality. This association is significant even for patients with blood glucose levels in the normal range, highlighting GV as a critical prognostic indicator.

Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Clinical Pathology

Background:

  • Glycemic control encompasses acute hyperglycemia, hypoglycemia, and glycemic variability (GV), all impacting patient outcomes.
  • Glycemic variability may confound results in tight glycemic control trials.

Purpose of the Study:

  • To investigate the relationship between glycemic variability and intensive care unit (ICU) mortality within the Indian population.
  • To assess GV as a prognostic marker in critically ill patients.

Main Methods:

  • Retrospective analysis of a prospectively collected database.
  • Inclusion of adult patients from Medical, Surgical, Trauma, and Neuro ICUs at a tertiary care hospital.
  • Analysis of patients with at least four blood glucose measurements during their ICU stay.

Main Results:

  • A cohort of 2208 patients with 11,335 blood glucose values was analyzed.
  • Both standard deviation (SD) and glycemic lability index (GLI) of blood glucose were significantly associated with increased ICU mortality (P < 0.001).
  • Elevated GV correlated with higher mortality, particularly in patients with blood glucose levels within the euglycemic range.

Conclusions:

  • Increased glycemic variability is a significant predictor of higher ICU mortality in a diverse group of critically ill patients.
  • The prognostic impact of GV is pronounced even when blood glucose levels are within the euglycemic range.
Abstract

Keywords:
Critically illglycemic lability indexglycemic variabilityhypoglycemiaintensive care unit mortality

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