In-Hospital Glycemic Variability and Mean Blood Glucose as Risk Markers for Long-Term Mortality in Patients with...

Area of Science:

• Endocrinology
• Internal Medicine
• Geriatrics

Background:

• Diabetes Mellitus (DM) management during hospitalization is critical.
• Glycemic control, including mean glucose (MG) and glycemic variability (GV), impacts patient outcomes.
• Understanding the relationship between in-hospital glucose metrics and post-discharge mortality is essential for risk stratification.

Purpose of the Study:

• To evaluate the influence of mean blood glucose (MG) and glycemic variability (GV) during hospitalization on post-discharge mortality risk in patients with diabetes mellitus (DM).
• To assess the predictive value of MG and GV for mortality in DM patients, adjusting for confounding factors.

Main Methods:

• Retrospective cohort study of 276 DM patients admitted to Internal Medicine.
• Calculation of MG, standard deviation (SD), and coefficient of variation (CV = SD/MG) from capillary glucose levels.
• Multivariate Cox regression analysis to identify independent predictors of post-discharge mortality.

Main Results:

• A total of 276 patients (mean age 77.6 years, 52.9% male) were included.
• During a median follow-up of 2.7 years, 90.2% of patients died.
• Elevated CV (> 0.29) and MG (> 140 mg/dL) were independent predictors of mortality (HR=1.60 and HR=1.71, respectively).

Conclusions:

• In-hospital mean blood glucose and glycemic variability are significant predictors of mortality in patients with diabetes mellitus.
• Measuring MG and GV during hospitalization can aid in stratifying post-discharge mortality risk.
• These findings highlight the importance of monitoring glycemic control beyond average levels in hospitalized DM patients.