Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus
Aims/Introduction We aimed to identify factors – glycemic control, reactive inflammatory biomarkers or vital signs – associated with mortality in diabetic patients admitted to hospital for various infections (non‐intensive care unit). Materials and Methods We retrospectively analyzed the cases of 62...
Gespeichert in:
| Veröffentlicht in: | Journal of diabetes investigation 2016-05, Vol.7 (3), p.429-435 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 435 |
|---|---|
| container_issue | 3 |
| container_start_page | 429 |
| container_title | Journal of diabetes investigation |
| container_volume | 7 |
| creator | Takeishi, Soichi Mori, Akihiro Hachiya, Hiroki Yumura, Takayuki Ito, Shun Shibuya, Takashi Hayashi, Shintaro Fushimi, Nobutoshi Ohashi, Noritsugu Kawai, Hiromi |
| description | Aims/Introduction
We aimed to identify factors – glycemic control, reactive inflammatory biomarkers or vital signs – associated with mortality in diabetic patients admitted to hospital for various infections (non‐intensive care unit).
Materials and Methods
We retrospectively analyzed the cases of 620 diabetic patients admitted to hospital for various infections (non‐intensive care unit) who underwent glucose monitoring >3 times per day. We extracted data regarding reactive inflammatory biomarkers and vital signs recorded on day 1 of hospital stay, and data on bacteremia and hypoglycemia status, glycemic variability (GV; coefficient of variation and standard deviation) and mean glucose concentrations during the entire hospital stay. Univariate and stepwise multivariate logistic regression analyses were carried out to determine the association between these factors and mortality.
Results
The mortality rate was 10.1%. Reactive inflammatory biomarkers, vital signs and bacteremia were not associated with mortality. According to the results of the adjusted analysis, hypoglycemia showed a significant positive association with mortality, increasing death risk by 266% (odds ratio [OR] 2.66, 95% confidence interval [95% CI] 1.22–5.83; P = 0.0006). High coefficient of variation and standard deviation values were significantly associated with increased mortality, increasing death risk by 18% (OR 1.18, 95% CI 1.01–1.38; P = 0.03) and 9% (OR 1.09, 95% CI 1.01–1.18; P = 0.03), respectively. Mean glucose concentrations were also significantly associated with mortality, increasing death risk by 5% (OR 1.05, 95% CI 1.02–1.08; P = 0.0008).
Conclusions
Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐intensive care unit diabetes mellitus patients with infections.
We aimed to identify factors―glycemic control, reactive inflammatory biomarkers, or vital signs―associated with mortality in diabetic patients admitted in hospital for various infections (non‐ICU). Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐ICU diabetes mellitus patients with infections. |
| doi_str_mv | 10.1111/jdi.12436 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4847899</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1799212723</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5286-9a50d1a6aefeac329cd39f83efdf16873f0f6a8f6f80c6dd5698f3e33121e9df3</originalsourceid><addsrcrecordid>eNqNksFuEzEQhlcIRKvSAy-ALHGBQ9q1vfHaFyTUAi2qxAXOlmuPm4l27bD2pgonHqGP0GfjSXC6IQIkJOZij-ab3zPWX1XPaX1CS5wuHZ5Q1nDxqDpkdVPPaMke7-9UHFTHKS3rElxKIdqn1QFrOa9bTg-r-4vNKt50Gws9GmKCI7vEkrUZ0Fxjh3lDzADEpBQtmgyO3GJekD4O2TxUMZAQw4_vdxgyhIRrIHbbMQbMZBHTCrfgt9KIwYPNGMdEHCYwCcjKZISQ0yTqypOQIZEeuqI9pmfVE2-6BMe786j68v7d57OL2dWnD5dnb69mds6kmCkzrx01woAHYzlT1nHlJQfvPBWy5b72wkgvvKytcG4ulPQcOKeMgnKeH1VvJt3VeN2Ds2WkwXR6NWBvho2OBvWflYALfRPXupFNK5UqAq92AkP8OkLKusdkyxYmQNlX01YpRlnL-H-gslWybZQo6Mu_0GUch1B-QjMmlVBNy2ihXk-UHWJKA_j93LTWW5fo4hL94JLCvvh90T35yxMFOJ2AW-xg828l_fH8cpL8CdkMzQE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2289694721</pqid></control><display><type>article</type><title>Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>PubMed Central</source><creator>Takeishi, Soichi ; Mori, Akihiro ; Hachiya, Hiroki ; Yumura, Takayuki ; Ito, Shun ; Shibuya, Takashi ; Hayashi, Shintaro ; Fushimi, Nobutoshi ; Ohashi, Noritsugu ; Kawai, Hiromi</creator><creatorcontrib>Takeishi, Soichi ; Mori, Akihiro ; Hachiya, Hiroki ; Yumura, Takayuki ; Ito, Shun ; Shibuya, Takashi ; Hayashi, Shintaro ; Fushimi, Nobutoshi ; Ohashi, Noritsugu ; Kawai, Hiromi</creatorcontrib><description>Aims/Introduction
We aimed to identify factors – glycemic control, reactive inflammatory biomarkers or vital signs – associated with mortality in diabetic patients admitted to hospital for various infections (non‐intensive care unit).
Materials and Methods
We retrospectively analyzed the cases of 620 diabetic patients admitted to hospital for various infections (non‐intensive care unit) who underwent glucose monitoring >3 times per day. We extracted data regarding reactive inflammatory biomarkers and vital signs recorded on day 1 of hospital stay, and data on bacteremia and hypoglycemia status, glycemic variability (GV; coefficient of variation and standard deviation) and mean glucose concentrations during the entire hospital stay. Univariate and stepwise multivariate logistic regression analyses were carried out to determine the association between these factors and mortality.
Results
The mortality rate was 10.1%. Reactive inflammatory biomarkers, vital signs and bacteremia were not associated with mortality. According to the results of the adjusted analysis, hypoglycemia showed a significant positive association with mortality, increasing death risk by 266% (odds ratio [OR] 2.66, 95% confidence interval [95% CI] 1.22–5.83; P = 0.0006). High coefficient of variation and standard deviation values were significantly associated with increased mortality, increasing death risk by 18% (OR 1.18, 95% CI 1.01–1.38; P = 0.03) and 9% (OR 1.09, 95% CI 1.01–1.18; P = 0.03), respectively. Mean glucose concentrations were also significantly associated with mortality, increasing death risk by 5% (OR 1.05, 95% CI 1.02–1.08; P = 0.0008).
Conclusions
Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐intensive care unit diabetes mellitus patients with infections.
We aimed to identify factors―glycemic control, reactive inflammatory biomarkers, or vital signs―associated with mortality in diabetic patients admitted in hospital for various infections (non‐ICU). Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐ICU diabetes mellitus patients with infections.</description><identifier>ISSN: 2040-1116</identifier><identifier>EISSN: 2040-1124</identifier><identifier>DOI: 10.1111/jdi.12436</identifier><identifier>PMID: 27330731</identifier><language>eng</language><publisher>Japan: John Wiley & Sons, Inc</publisher><subject>Aged ; Aged, 80 and over ; Bacteremia ; Biomarkers ; Biomarkers - metabolism ; Blood pressure ; Body mass index ; Body temperature ; Communicable Diseases - complications ; Communicable Diseases - diagnosis ; Communicable Diseases - mortality ; Death ; Diabetes ; Diabetes Complications - diagnosis ; Diabetes Complications - mortality ; Diabetes mellitus ; Etiology ; Female ; Glucose ; Glucose monitoring ; Glycemic Index ; Glycemic variability ; Heart rate ; Hemoglobin ; Hospital Mortality ; Hospitals ; Humans ; Hyperglycemia ; Hypoglycemia ; Hypoglycemia - complications ; Hypoglycemia - diagnosis ; Infections ; Infectious diseases ; Inflammation ; Inflammation - diagnosis ; Inflammation - metabolism ; Insulin resistance ; Intensive care ; Male ; Medical prognosis ; Mortality ; Original ; Oxidative stress ; Patients ; Pneumonia ; ROC Curve ; Standard deviation ; Studies ; Urogenital system ; Vital Signs</subject><ispartof>Journal of diabetes investigation, 2016-05, Vol.7 (3), p.429-435</ispartof><rights>2015 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd</rights><rights>2016. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5286-9a50d1a6aefeac329cd39f83efdf16873f0f6a8f6f80c6dd5698f3e33121e9df3</citedby><cites>FETCH-LOGICAL-c5286-9a50d1a6aefeac329cd39f83efdf16873f0f6a8f6f80c6dd5698f3e33121e9df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847899/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847899/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27330731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeishi, Soichi</creatorcontrib><creatorcontrib>Mori, Akihiro</creatorcontrib><creatorcontrib>Hachiya, Hiroki</creatorcontrib><creatorcontrib>Yumura, Takayuki</creatorcontrib><creatorcontrib>Ito, Shun</creatorcontrib><creatorcontrib>Shibuya, Takashi</creatorcontrib><creatorcontrib>Hayashi, Shintaro</creatorcontrib><creatorcontrib>Fushimi, Nobutoshi</creatorcontrib><creatorcontrib>Ohashi, Noritsugu</creatorcontrib><creatorcontrib>Kawai, Hiromi</creatorcontrib><title>Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus</title><title>Journal of diabetes investigation</title><addtitle>J Diabetes Investig</addtitle><description>Aims/Introduction
We aimed to identify factors – glycemic control, reactive inflammatory biomarkers or vital signs – associated with mortality in diabetic patients admitted to hospital for various infections (non‐intensive care unit).
Materials and Methods
We retrospectively analyzed the cases of 620 diabetic patients admitted to hospital for various infections (non‐intensive care unit) who underwent glucose monitoring >3 times per day. We extracted data regarding reactive inflammatory biomarkers and vital signs recorded on day 1 of hospital stay, and data on bacteremia and hypoglycemia status, glycemic variability (GV; coefficient of variation and standard deviation) and mean glucose concentrations during the entire hospital stay. Univariate and stepwise multivariate logistic regression analyses were carried out to determine the association between these factors and mortality.
Results
The mortality rate was 10.1%. Reactive inflammatory biomarkers, vital signs and bacteremia were not associated with mortality. According to the results of the adjusted analysis, hypoglycemia showed a significant positive association with mortality, increasing death risk by 266% (odds ratio [OR] 2.66, 95% confidence interval [95% CI] 1.22–5.83; P = 0.0006). High coefficient of variation and standard deviation values were significantly associated with increased mortality, increasing death risk by 18% (OR 1.18, 95% CI 1.01–1.38; P = 0.03) and 9% (OR 1.09, 95% CI 1.01–1.18; P = 0.03), respectively. Mean glucose concentrations were also significantly associated with mortality, increasing death risk by 5% (OR 1.05, 95% CI 1.02–1.08; P = 0.0008).
Conclusions
Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐intensive care unit diabetes mellitus patients with infections.
We aimed to identify factors―glycemic control, reactive inflammatory biomarkers, or vital signs―associated with mortality in diabetic patients admitted in hospital for various infections (non‐ICU). Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐ICU diabetes mellitus patients with infections.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacteremia</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Body temperature</subject><subject>Communicable Diseases - complications</subject><subject>Communicable Diseases - diagnosis</subject><subject>Communicable Diseases - mortality</subject><subject>Death</subject><subject>Diabetes</subject><subject>Diabetes Complications - diagnosis</subject><subject>Diabetes Complications - mortality</subject><subject>Diabetes mellitus</subject><subject>Etiology</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose monitoring</subject><subject>Glycemic Index</subject><subject>Glycemic variability</subject><subject>Heart rate</subject><subject>Hemoglobin</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - complications</subject><subject>Hypoglycemia - diagnosis</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Inflammation</subject><subject>Inflammation - diagnosis</subject><subject>Inflammation - metabolism</subject><subject>Insulin resistance</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Original</subject><subject>Oxidative stress</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>ROC Curve</subject><subject>Standard deviation</subject><subject>Studies</subject><subject>Urogenital system</subject><subject>Vital Signs</subject><issn>2040-1116</issn><issn>2040-1124</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqNksFuEzEQhlcIRKvSAy-ALHGBQ9q1vfHaFyTUAi2qxAXOlmuPm4l27bD2pgonHqGP0GfjSXC6IQIkJOZij-ab3zPWX1XPaX1CS5wuHZ5Q1nDxqDpkdVPPaMke7-9UHFTHKS3rElxKIdqn1QFrOa9bTg-r-4vNKt50Gws9GmKCI7vEkrUZ0Fxjh3lDzADEpBQtmgyO3GJekD4O2TxUMZAQw4_vdxgyhIRrIHbbMQbMZBHTCrfgt9KIwYPNGMdEHCYwCcjKZISQ0yTqypOQIZEeuqI9pmfVE2-6BMe786j68v7d57OL2dWnD5dnb69mds6kmCkzrx01woAHYzlT1nHlJQfvPBWy5b72wkgvvKytcG4ulPQcOKeMgnKeH1VvJt3VeN2Ds2WkwXR6NWBvho2OBvWflYALfRPXupFNK5UqAq92AkP8OkLKusdkyxYmQNlX01YpRlnL-H-gslWybZQo6Mu_0GUch1B-QjMmlVBNy2ihXk-UHWJKA_j93LTWW5fo4hL94JLCvvh90T35yxMFOJ2AW-xg828l_fH8cpL8CdkMzQE</recordid><startdate>201605</startdate><enddate>201605</enddate><creator>Takeishi, Soichi</creator><creator>Mori, Akihiro</creator><creator>Hachiya, Hiroki</creator><creator>Yumura, Takayuki</creator><creator>Ito, Shun</creator><creator>Shibuya, Takashi</creator><creator>Hayashi, Shintaro</creator><creator>Fushimi, Nobutoshi</creator><creator>Ohashi, Noritsugu</creator><creator>Kawai, Hiromi</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201605</creationdate><title>Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus</title><author>Takeishi, Soichi ; Mori, Akihiro ; Hachiya, Hiroki ; Yumura, Takayuki ; Ito, Shun ; Shibuya, Takashi ; Hayashi, Shintaro ; Fushimi, Nobutoshi ; Ohashi, Noritsugu ; Kawai, Hiromi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5286-9a50d1a6aefeac329cd39f83efdf16873f0f6a8f6f80c6dd5698f3e33121e9df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacteremia</topic><topic>Biomarkers</topic><topic>Biomarkers - metabolism</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Body temperature</topic><topic>Communicable Diseases - complications</topic><topic>Communicable Diseases - diagnosis</topic><topic>Communicable Diseases - mortality</topic><topic>Death</topic><topic>Diabetes</topic><topic>Diabetes Complications - diagnosis</topic><topic>Diabetes Complications - mortality</topic><topic>Diabetes mellitus</topic><topic>Etiology</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose monitoring</topic><topic>Glycemic Index</topic><topic>Glycemic variability</topic><topic>Heart rate</topic><topic>Hemoglobin</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - complications</topic><topic>Hypoglycemia - diagnosis</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Inflammation</topic><topic>Inflammation - diagnosis</topic><topic>Inflammation - metabolism</topic><topic>Insulin resistance</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Original</topic><topic>Oxidative stress</topic><topic>Patients</topic><topic>Pneumonia</topic><topic>ROC Curve</topic><topic>Standard deviation</topic><topic>Studies</topic><topic>Urogenital system</topic><topic>Vital Signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takeishi, Soichi</creatorcontrib><creatorcontrib>Mori, Akihiro</creatorcontrib><creatorcontrib>Hachiya, Hiroki</creatorcontrib><creatorcontrib>Yumura, Takayuki</creatorcontrib><creatorcontrib>Ito, Shun</creatorcontrib><creatorcontrib>Shibuya, Takashi</creatorcontrib><creatorcontrib>Hayashi, Shintaro</creatorcontrib><creatorcontrib>Fushimi, Nobutoshi</creatorcontrib><creatorcontrib>Ohashi, Noritsugu</creatorcontrib><creatorcontrib>Kawai, Hiromi</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of diabetes investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takeishi, Soichi</au><au>Mori, Akihiro</au><au>Hachiya, Hiroki</au><au>Yumura, Takayuki</au><au>Ito, Shun</au><au>Shibuya, Takashi</au><au>Hayashi, Shintaro</au><au>Fushimi, Nobutoshi</au><au>Ohashi, Noritsugu</au><au>Kawai, Hiromi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus</atitle><jtitle>Journal of diabetes investigation</jtitle><addtitle>J Diabetes Investig</addtitle><date>2016-05</date><risdate>2016</risdate><volume>7</volume><issue>3</issue><spage>429</spage><epage>435</epage><pages>429-435</pages><issn>2040-1116</issn><eissn>2040-1124</eissn><abstract>Aims/Introduction
We aimed to identify factors – glycemic control, reactive inflammatory biomarkers or vital signs – associated with mortality in diabetic patients admitted to hospital for various infections (non‐intensive care unit).
Materials and Methods
We retrospectively analyzed the cases of 620 diabetic patients admitted to hospital for various infections (non‐intensive care unit) who underwent glucose monitoring >3 times per day. We extracted data regarding reactive inflammatory biomarkers and vital signs recorded on day 1 of hospital stay, and data on bacteremia and hypoglycemia status, glycemic variability (GV; coefficient of variation and standard deviation) and mean glucose concentrations during the entire hospital stay. Univariate and stepwise multivariate logistic regression analyses were carried out to determine the association between these factors and mortality.
Results
The mortality rate was 10.1%. Reactive inflammatory biomarkers, vital signs and bacteremia were not associated with mortality. According to the results of the adjusted analysis, hypoglycemia showed a significant positive association with mortality, increasing death risk by 266% (odds ratio [OR] 2.66, 95% confidence interval [95% CI] 1.22–5.83; P = 0.0006). High coefficient of variation and standard deviation values were significantly associated with increased mortality, increasing death risk by 18% (OR 1.18, 95% CI 1.01–1.38; P = 0.03) and 9% (OR 1.09, 95% CI 1.01–1.18; P = 0.03), respectively. Mean glucose concentrations were also significantly associated with mortality, increasing death risk by 5% (OR 1.05, 95% CI 1.02–1.08; P = 0.0008).
Conclusions
Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐intensive care unit diabetes mellitus patients with infections.
We aimed to identify factors―glycemic control, reactive inflammatory biomarkers, or vital signs―associated with mortality in diabetic patients admitted in hospital for various infections (non‐ICU). Glycemic indices (especially hypoglycemia and GV), rather than reactive inflammatory biomarkers or vital signs, were associated with mortality in non‐ICU diabetes mellitus patients with infections.</abstract><cop>Japan</cop><pub>John Wiley & Sons, Inc</pub><pmid>27330731</pmid><doi>10.1111/jdi.12436</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2040-1116 |
| ispartof | Journal of diabetes investigation, 2016-05, Vol.7 (3), p.429-435 |
| issn | 2040-1116 2040-1124 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4847899 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Access via Wiley Online Library; EZB-FREE-00999 freely available EZB journals; Wiley Online Library (Open Access Collection); PubMed Central |
| subjects | Aged Aged, 80 and over Bacteremia Biomarkers Biomarkers - metabolism Blood pressure Body mass index Body temperature Communicable Diseases - complications Communicable Diseases - diagnosis Communicable Diseases - mortality Death Diabetes Diabetes Complications - diagnosis Diabetes Complications - mortality Diabetes mellitus Etiology Female Glucose Glucose monitoring Glycemic Index Glycemic variability Heart rate Hemoglobin Hospital Mortality Hospitals Humans Hyperglycemia Hypoglycemia Hypoglycemia - complications Hypoglycemia - diagnosis Infections Infectious diseases Inflammation Inflammation - diagnosis Inflammation - metabolism Insulin resistance Intensive care Male Medical prognosis Mortality Original Oxidative stress Patients Pneumonia ROC Curve Standard deviation Studies Urogenital system Vital Signs |
| title | Hypoglycemia and glycemic variability are associated with mortality in non‐intensive care unit hospitalized infectious disease patients with diabetes mellitus |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T21%3A18%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hypoglycemia%20and%20glycemic%20variability%20are%20associated%20with%20mortality%20in%20non%E2%80%90intensive%20care%20unit%20hospitalized%20infectious%20disease%20patients%20with%20diabetes%20mellitus&rft.jtitle=Journal%20of%20diabetes%20investigation&rft.au=Takeishi,%20Soichi&rft.date=2016-05&rft.volume=7&rft.issue=3&rft.spage=429&rft.epage=435&rft.pages=429-435&rft.issn=2040-1116&rft.eissn=2040-1124&rft_id=info:doi/10.1111/jdi.12436&rft_dat=%3Cproquest_pubme%3E1799212723%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2289694721&rft_id=info:pmid/27330731&rfr_iscdi=true |