• Wan-Jie Gu, You-Dong Wan, Hong-Tao Tie, Quan-Cheng Kan, and Tong-Wen Sun.
• Department of Anaesthesiology, the First Affiliated Hospital, Guangxi Medical University, Nanning, China ; Department of Integrated Intensive Care Unit, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
• Plos One. 2014 Jan 1;9(2):e90426.

BackgroundThe impact of pre-existing diabetes on the development of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in critically ill patients remains unclear. We performed a meta-analysis of cohort studies to evaluate the risk of ALI/ARDS in critically ill patients with and without pre-existing diabetes.Materials And MethodsWe searched PubMed and Embase from the inception to September 2013 for cohort studies assessing the effect of pre-existing diabetes on ALI/ARDS occurrence. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using random- or fixed-effect models when appropriate.ResultsSeven cohort studies with a total of 12,794 participants and 2,937 cases of pre-existing diabetes, and 2,457 cases of ALI/ARDS were included in the meta-analysis. A fixed-effects model meta-analysis showed that pre-existing diabetes was associated with a reduced risk of ALI/ARDS (OR 0.66; 95% CI, 0.55-0.80; p<0.001), with low heterogeneity among the studies (I(2)=18.9%; p=0.286). However, the asymmetric funnel plot and Egger's test (p=0.007) suggested publication bias may exist.ConclusionsOur meta-analysis suggests that pre-existing diabetes was associated with a decreased risk of ALI/ARDS in critically ill adult patients. However, the result should be interpreted with caution because of the potential bias and confounding in the included studies.

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