• Journal of critical care · Apr 2017

    Hyperglycemia and glycemic variability are associated with the severity of sepsis in nondiabetic subjects.

    • Lukana Preechasuk, Nattakarn Suwansaksri, Nantawan Ipichart, Sathit Vannasaeng, Chairat Permpikul, and Apiradee Sriwijitkamol.
    • Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
    • J Crit Care. 2017 Apr 1; 38: 319-323.

    PurposeThe purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients.MethodsNondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours. Sepsis severity was evaluated with the Sepsis-related Organ Failure Assessment Score (SOFA). MGL and GV in patients with SOFA ≥9 and <9 were compared.ResultsThirty nondiabetic sepsis and 10 healthy subjects were recruited. No differences were found between groups except for higher patient age in sepsis patients. The MGL and MAGE72h of sepsis patients were significantly higher than those of healthy subjects. MGL and GV24h were higher in patients with SOFA ≥9 than in patients with SOFA <9 (MGL24h 195±17 vs 139±27, P<.001; SD24h 32 [28, 36] vs 19 [5, 58], P=.02; and MAGE24h 94 [58, 153] vs 54 [16, 179], P=.01).ConclusionNondiabetic sepsis patients had higher MGL and GV values than healthy subjects. MGL and GV24h were associated with sepsis severity.Copyright © 2016 Elsevier Inc. All rights reserved.

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