Glucose variability and ICU outcome
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KeywordsBlood Sugar Glycemic Variability Glucose Variability Teaching Tertiary Care Hospital Blood Sugar Control
Glycemic excursion or glucose variability (GV) was explored recently as a contributor of mortality, when studies concentrating on strict blood sugar control failed to show consistent results. The objective of this study was to determine the implication of glucose variability on ICU mortality in a heterogeneous ICU population.
The study was conducted in a medical/surgical ICU (45 beds) in a private teaching tertiary care hospital in India. A nurse-driven subcutaneous and intravenous insulin protocol (modified Yale) was followed for sugar control with a target CBG of ≤150 mg/dl. Blood sugar was checked as per patient requirement, both by point-of care-testing and central laboratory. The outcome measure was ICU mortality. From the prospectively collected glucose values, mean blood glucose (MBG) was measured for each patient and glycemic variability (GV) calculated as the standard deviation (SD) and glycemic lability index of MBG. GV was correlated with mortality.
In summary, this study demonstrated that glucose variability is associated with ICU mortality in a large heterogeneous cohort of ICU patients. This effect was particularly strong among patients in the euglycemic range.
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