Glucose intolerance in intensive care patients: Incidence and outcome
ABSTRACTBackground: Critical illness is associated with modification in metabolic status. Insulin resistance and elevated blood glucose levels occur during stressful conditions. We aimed to evaluate the incidence and outcome of glucose intolerance in intensive care patients.Material and methods: Thi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2020.1864253 |
| _version_ | 1827816494467121152 |
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| author | Ahmed A. El Shebiny Gamal M. Elewa Ez Alregal G. Gouda Reham Mustafa Hashim |
| author_facet | Ahmed A. El Shebiny Gamal M. Elewa Ez Alregal G. Gouda Reham Mustafa Hashim |
| author_sort | Ahmed A. El Shebiny |
| collection | DOAJ |
| description | ABSTRACTBackground: Critical illness is associated with modification in metabolic status. Insulin resistance and elevated blood glucose levels occur during stressful conditions. We aimed to evaluate the incidence and outcome of glucose intolerance in intensive care patients.Material and methods: This prospective clinical study included 290 patients, admitted to the intensive care unit (ICU). They were divided into three groups according to the maximum blood glucose level on admission and after 48 hours of admission: Normoglycemic, hyperglycemic, and hypoglycemic. Each group was subdivided into diabetic and non-diabetic. Patients’ age, sex, APACHE II, and causes of admission were recorded. Use of vasopressor and corticosteroid therapy, type of feeding, days on mechanical ventilation, total days of stay in ICU, and fate of patients were recorded.Results: Hyperglycemia was common in critically ill patients with 68.6% and 86.2% incidence on ICU admission and after 48 hours of admission, respectively. Sixty percent of the patients were diabetic. Hyperglycemia was associated with increased morbidity in the form of difficult weaning from mechanical ventilation and long ICU stay. Of hyperglycemic patients, 66.4% were orally fed. The mortality incidence among normoglycemic patients was 37.5%; which was lower than the mortality among hyperglycemic patients (39.2%), but without a statistically significant difference. Glucose intolerance was not related to the severity of the disease or cause of admission. Vasopressors and steroids were not risking factors during the initial 48 hours of admission.Conclusion: Glucose intolerance is high in intensive care patients and is associated with high morbidity and mortality. |
| first_indexed | 2024-03-12T00:20:24Z |
| format | Article |
| id | doaj.art-9d6a26a86dde4ffd9765a86849bd8ad4 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-03-12T00:20:24Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-9d6a26a86dde4ffd9765a86849bd8ad42023-09-15T13:38:33ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492021-01-01371283410.1080/11101849.2020.1864253Glucose intolerance in intensive care patients: Incidence and outcomeAhmed A. El Shebiny0Gamal M. Elewa1Ez Alregal G. Gouda2Reham Mustafa Hashim3Anesthesia, ICU, and Pain Management, Faculty of Medicine , Ain Shams University, Cairo, EgyptAnesthesia, ICU, and Pain Management, Faculty of Medicine , Ain Shams University, Cairo, EgyptFaculty of Medicine, Cairo University, Ain Shams University, Cairo, EgyptAnesthesia, ICU, and Pain Management, Faculty of Medicine , Ain Shams University, Cairo, EgyptABSTRACTBackground: Critical illness is associated with modification in metabolic status. Insulin resistance and elevated blood glucose levels occur during stressful conditions. We aimed to evaluate the incidence and outcome of glucose intolerance in intensive care patients.Material and methods: This prospective clinical study included 290 patients, admitted to the intensive care unit (ICU). They were divided into three groups according to the maximum blood glucose level on admission and after 48 hours of admission: Normoglycemic, hyperglycemic, and hypoglycemic. Each group was subdivided into diabetic and non-diabetic. Patients’ age, sex, APACHE II, and causes of admission were recorded. Use of vasopressor and corticosteroid therapy, type of feeding, days on mechanical ventilation, total days of stay in ICU, and fate of patients were recorded.Results: Hyperglycemia was common in critically ill patients with 68.6% and 86.2% incidence on ICU admission and after 48 hours of admission, respectively. Sixty percent of the patients were diabetic. Hyperglycemia was associated with increased morbidity in the form of difficult weaning from mechanical ventilation and long ICU stay. Of hyperglycemic patients, 66.4% were orally fed. The mortality incidence among normoglycemic patients was 37.5%; which was lower than the mortality among hyperglycemic patients (39.2%), but without a statistically significant difference. Glucose intolerance was not related to the severity of the disease or cause of admission. Vasopressors and steroids were not risking factors during the initial 48 hours of admission.Conclusion: Glucose intolerance is high in intensive care patients and is associated with high morbidity and mortality.https://www.tandfonline.com/doi/10.1080/11101849.2020.1864253Acute Physiology and Chronic Evaluation (APACHE II) scoreintensive care unitglucose intolerancediabetes mellitus (DM) |
| spellingShingle | Ahmed A. El Shebiny Gamal M. Elewa Ez Alregal G. Gouda Reham Mustafa Hashim Glucose intolerance in intensive care patients: Incidence and outcome Egyptian Journal of Anaesthesia Acute Physiology and Chronic Evaluation (APACHE II) score intensive care unit glucose intolerance diabetes mellitus (DM) |
| title | Glucose intolerance in intensive care patients: Incidence and outcome |
| title_full | Glucose intolerance in intensive care patients: Incidence and outcome |
| title_fullStr | Glucose intolerance in intensive care patients: Incidence and outcome |
| title_full_unstemmed | Glucose intolerance in intensive care patients: Incidence and outcome |
| title_short | Glucose intolerance in intensive care patients: Incidence and outcome |
| title_sort | glucose intolerance in intensive care patients incidence and outcome |
| topic | Acute Physiology and Chronic Evaluation (APACHE II) score intensive care unit glucose intolerance diabetes mellitus (DM) |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2020.1864253 |
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