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Association Between Blood Glucose Variability and Clinical Outcomes in Patients With Sepsis: A Systematic Review and
Gelan Miao1, Rui Lu1,2, Tanyong Pipanmekaporn3,4
1Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Diabetes/Metabolism Research and Reviews
|January 4, 2026
Summary
High glycemic variability (GV) significantly increases mortality risk in sepsis patients. Specific metrics like GLI and MAGE are more reliable for predicting outcomes than others.
Area of Science:
- Critical care medicine
- Endocrinology
- Clinical research
Background:
- Glycemic variability (GV) is a key prognostic factor in critical illness.
- The predictive value of GV in sepsis patients requires further clarification.
Purpose of the Study:
- To systematically review and meta-analyze the association between GV metrics and mortality in adult sepsis patients.
Main Methods:
- Systematic review and meta-analysis of cohort studies.
- Searched PubMed, Embase, Cochrane Library, Scopus, CNKI, and Wanfang databases.
- Pooled odds ratios (ORs) calculated using random-effects model; sensitivity analyses performed.
Main Results:
- Ten studies (18,337 patients) included.
- High GV associated with nearly double the mortality risk (OR = 1.99).
- Continuous GV metrics (CoV, SD, GLI, MAGE) all linked to mortality; GLI and MAGE showed greater consistency.
Conclusions:
- Elevated GV is an independent predictor of mortality in sepsis.
- GLI and MAGE are most reliable for prognostic assessment in sepsis.
- Standardized GV measurement and targeted interventions require further investigation.
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