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Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients

Nondiabetic hyperglycemia is a dangerous metabolic phenomenon in the intensive care unit. Inattentive treatment of glycemic disorders is a serious health hazard promoting negative outcomes. The aim of our study was to assess glycemic variability and its basic determinants, and to verify its relation...

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Autores principales: Kapłan, Cezary, Kalemba, Alicja, Krok, Monika, Krzych, Łukasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026687/
https://www.ncbi.nlm.nih.gov/pubmed/35457586
http://dx.doi.org/10.3390/ijerph19084717
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author Kapłan, Cezary
Kalemba, Alicja
Krok, Monika
Krzych, Łukasz
author_facet Kapłan, Cezary
Kalemba, Alicja
Krok, Monika
Krzych, Łukasz
author_sort Kapłan, Cezary
collection PubMed
description Nondiabetic hyperglycemia is a dangerous metabolic phenomenon in the intensive care unit. Inattentive treatment of glycemic disorders is a serious health hazard promoting negative outcomes. The aim of our study was to assess glycemic variability and its basic determinants, and to verify its relationship with mortality in patients hospitalized in a mixed ICU (intensive care unit). The medical records of 37 patients hospitalized 13 January–29 February 2020 were analyzed prospectively. The BG (blood glucose) variability during the stay was assessed using two definitions, i.e., the value of standard deviation (SD) from all the measurements performed and the coefficient of variation (CV). A correlation between the BG variability and insulin dose was observed (SD: R = 0.559; p < 0.01; CV: R = 0.621; p < 0.01). There was also a correlation between the BG variability and the total energy daily dose (SD: R = 0.373; p = 0.02; CV: R = 0.364; p = 0.03). Glycemic variability was higher among patients to whom treatment with adrenalin (p = 0.0218) or steroid (p = 0.0292) was applied. The BG variability, expressed using SD, was associated with ICU mortality (ROC = 0.806; 95% CI: 0.643–0.917; p = 0.0014). The BG variability in the ICU setting arises from the loss of balance between the supplied energy and the applied insulin dose and may be associated with a worse prognosis.
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spelling pubmed-90266872022-04-23 Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients Kapłan, Cezary Kalemba, Alicja Krok, Monika Krzych, Łukasz Int J Environ Res Public Health Article Nondiabetic hyperglycemia is a dangerous metabolic phenomenon in the intensive care unit. Inattentive treatment of glycemic disorders is a serious health hazard promoting negative outcomes. The aim of our study was to assess glycemic variability and its basic determinants, and to verify its relationship with mortality in patients hospitalized in a mixed ICU (intensive care unit). The medical records of 37 patients hospitalized 13 January–29 February 2020 were analyzed prospectively. The BG (blood glucose) variability during the stay was assessed using two definitions, i.e., the value of standard deviation (SD) from all the measurements performed and the coefficient of variation (CV). A correlation between the BG variability and insulin dose was observed (SD: R = 0.559; p < 0.01; CV: R = 0.621; p < 0.01). There was also a correlation between the BG variability and the total energy daily dose (SD: R = 0.373; p = 0.02; CV: R = 0.364; p = 0.03). Glycemic variability was higher among patients to whom treatment with adrenalin (p = 0.0218) or steroid (p = 0.0292) was applied. The BG variability, expressed using SD, was associated with ICU mortality (ROC = 0.806; 95% CI: 0.643–0.917; p = 0.0014). The BG variability in the ICU setting arises from the loss of balance between the supplied energy and the applied insulin dose and may be associated with a worse prognosis. MDPI 2022-04-13 /pmc/articles/PMC9026687/ /pubmed/35457586 http://dx.doi.org/10.3390/ijerph19084717 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kapłan, Cezary
Kalemba, Alicja
Krok, Monika
Krzych, Łukasz
Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title_full Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title_fullStr Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title_full_unstemmed Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title_short Effect of Treatment and Nutrition on Glycemic Variability in Critically Ill Patients
title_sort effect of treatment and nutrition on glycemic variability in critically ill patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9026687/
https://www.ncbi.nlm.nih.gov/pubmed/35457586
http://dx.doi.org/10.3390/ijerph19084717
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