Hyperglycemia in the Intensive Care Unit, a Prevalence Study

2014-08-27 03:23:55 | BioPortfolio


Hyperglycemia is very common among critically ill patients, even in the absence of diagnosed diabetes or pre-diabetes.

We aimed to determine the prevalence of occult glucose metabolism abnormalities in a general intensive care unit (ICU) and hypothesized that hyperglycemia severity, as reflected by insulin requirements for maintenance of normoglycemia, could be used as a tool to identify high risk patients.


100 consecutive adults patients with an expected stay of 24 hours or more admitted to the Sacré-Coeur Hospital ICU between November 2005 and March 2006 were eligible for enrollment. Our hospital is a 28 beds ICU tertiary center affiliated with the University of Montreal. We have a mixed medical and surgical ICU units treating patients with a variety of conditions including sepsis, respiratory failure, circulatory insufficiency, trauma, as well as cardiac, thoracic and vascular surgery. We excluded patients with a previous diagnosis of diabetes or pre-diabetes. Patients admitted for diabetic ketoacidosis or hyperglycemic hyperosmolar states, treated with chronic corticosteroid therapy at supraphysiological doses or enrolled in another exclusive study were also excluded.

Data collection

At time of admission, demographic data were collected and classical risk factors for diabetes, including high blood pressure, dyslipidemia, coronary artery disease, vascular disease and family history of type 2 diabetes were assessed. Corticosteroid exposure in the 72 hours preceding admission was noted. Physiology and laboratory data were collected for calculation of the Acute Physiologic and Chronic Health Evaluation (APACHE-II) score of illness severity. For each patient, body mass index (BMI) was calculated and waist circumference was measured according to standard technique .

All patients had strict glycemic control according to local regular insulin protocol. Bedside glucose measurements were made every two to four hours using a calibrated plasma glucometer (EliteTM by Bayer). We calculated the daily and cumulative insulin dose administered during the first 72 hours in the ICU in order to maintain a blood glucose level between 72 and 126 mg per deciliter. Co-treatment with other forms of insulin and oral hypoglycaemic agents was prohibited during the study. The daily caloric intake, including feeding, dextrose solution, medication diluent and propofol, as well as the corticosteroids and vasopressors received during that period of time were also calculated.

Random plasma glucose level and glycated hemoglobin (A1C, Homogenous Immunoturbimetric Assay) were measured at baseline. Three months after ICU admission, a second value of A1C was obtained and a standard 75g Oral Glucose Tolerance Test (OGTT) was performed. Based on the OGTT results, patients were classified as having normal or abnormal glucose metabolism according to the criteria published by the American Diabetes Association.

Study Design

Observational Model: Cohort, Time Perspective: Prospective






University of Montreal

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:23:55-0400

Clinical Trials [112 Associated Clinical Trials listed on BioPortfolio]

Stress Induced Hyperglycemia In Trauma

The clinical relevance of the observed stress induced hyperglycemia in trauma patients remains unclear. The earlier studies suggested the implications of cytokines in stress induced hyperg...

Effects of Hyperglycemia During Cardiopulmonary Bypass on Renal Function

To determine whether intraoperative hyperglycemia potentiates renal injury in the setting of cardiac surgery requiring cardiopulmonary bypass.

Metabolic Phenotyping During Stress Hyperglycemia in Cardiac Surgery Patients

The study is a prospective randomized study to examine the effects of exposure to dulaglutide on the prevention of stress-hyperglycemia and the metabolic inflammatory response in the perio...

Hyperglycemia in a Coronary Intensive Care Unit

Newly diagnosed hyperglycemia (NDH) and stress hyperglycemia (SH) during acute illness is reported as a non-physiological condition in hospitals. The investigators aim is to determine the ...

The Metabolic Effects of Acute Hyperglycemia in Patients With Type 2 Diabetes

The purpose of the study is to characterize the changes in amino acid, lipid and glucose metabolism in patients with type 2 diabetes exposed to acute hyperglycemia. Moreover we wish to ass...

PubMed Articles [316 Associated PubMed Articles listed on BioPortfolio]

Is reduction of hyperglycemia associated with a cardiovascular benefit?

We have a large body of evidence showing that hyperglycemia is a cardiovascular risk factor and that its reduction decreases the risk for cardiovascular events. Indeed, epidemiological studies have cl...

Etiology of hyperglycemia in critically ill children and the impact of organ dysfunction.

This study aimed to study the incidence of stress hyperglycemia in critically ill children and to investigate the etiological basis of the hyperglycemia based on homeostasis model assessment.

Fasting Blood Glucose Levels Provide Estimate of Duration and Progression of Pancreatic Cancer before Diagnosis.

It is unclear how long pancreatic ductal adenocarcinomas (PDACs) are present before diagnosis. Patients with PDAC usually develop hyperglycemia and diabetes before the tumor is identified. If early in...

Impact of varying levels of hyperglycemia on clinicoradiographic outcomes after endovascular reperfusion treatment.

We evaluated the effects of admission hyperglycemia with different cut-off levels on 3-month outcomes, infarct growth, and hemorrhagic transformation in acute stroke patients with large artery occlusi...

Update on glucose in critical care.

The aim of this review is to summarize recent developments on the mechanisms involved in stress hyperglycemia associated with critical illness. Different aspects of the consequences of stress hypergly...

Medical and Biotech [MESH] Definitions

Abnormally high BLOOD GLUCOSE level.

A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.

The appearance of an abnormally large amount of GLUCOSE in the urine, such as more than 500 mg/day in adults. It can be due to HYPERGLYCEMIA or genetic defects in renal reabsorption (RENAL GLYCOSURIA).

A state of unconsciousness as a complication of diabetes mellitus. It occurs in cases of extreme HYPERGLYCEMIA or extreme HYPOGLYCEMIA as a complication of INSULIN therapy.

A serious complication of TYPE 2 DIABETES MELLITUS. It is characterized by extreme HYPERGLYCEMIA; DEHYDRATION; serum hyperosmolarity; and depressed consciousness leading to COMA in the absence of KETOSIS and ACIDOSIS.

More From BioPortfolio on "Hyperglycemia in the Intensive Care Unit, a Prevalence Study"

Quick Search


Relevant Topic

Surgical treatments
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...

Searches Linking to this Trial