• Nora Luethi, Luca Cioccari, Aiko Tanaka, Palash Kar, Emma Giersch, Adam M Deane, Johan Mårtensson, and Rinaldo Bellomo.
• 1Department of Intensive Care, Austin Hospital, The University of Melbourne, Melbourne, VIC, Australia.2Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.3Discipline of Acute Care Medicine, Department of Intensive Care, University of Adelaide, Adelaide, SA, Australia.4Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.5Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
• Crit. Care Med. 2016 Sep 1; 44 (9): 1692-4.

ObjectivesGlycated hemoglobin A1c is used to estimate glycemic control. However, its value upon ICU admission may be altered by critical illness and not reflect true glycemic status. We assessed the relationship between ICU admission glycated hemoglobin A1c and premorbid glycated hemoglobin A1c levels.DesignRetrospective observational cohort study.SettingTwo tertiary ICUs in Australia.PatientsCohort of 69 critically ill patients with diabetes and glycated hemoglobin A1c levels measured upon ICU admission and during the month prior to admission.InterventionsMeasurement of glycated hemoglobin A1c.Measurements And Main ResultsMean (SD) glycated hemoglobin A1c level was 7.5% (1.8%) upon ICU admission and 7.8% (2.0%) in previous measurements from the preceding 30 days. The change in glycated hemoglobin A1c did not correlate with time elapsed between the two measurements (r = 0.00005; p = 0.95), but there was a strong correlation between admission glycated hemoglobin A1c levels and premorbid glycated hemoglobin A1c levels (r = 0.89; p < 0.001).ConclusionsGlycated hemoglobin A1c levels are not altered by the onset of critical illness. Glycated hemoglobin A1c quantified at ICU admission can, therefore, be used to reliably estimate chronic glycemic control and guide acute glycemic therapy.

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