Newly diagnosed hyperglycemia and stress hyperglycemia in a coronary intensive care unit

Diabetes Res Clin Pract. 2010 Oct;90(1):8-14. doi: 10.1016/j.diabres.2010.05.023. Epub 2010 Jul 31.

Abstract

Aims: To determine prevalence of newly diagnosed hyperglycemia (NDH) among patients with acute coronary disease, inquire relationship of stress hyperglycemia (SH) with functional outcomes.

Methods: Admission (APG) and first morning fasting plasma glucose (FPG) measurements were obtained, capillary glucose measurements (CGM) every 6-h within first day were performed-Group 1: Normoglycemics. Group 2: NDH cases: No known diabetes, APG>200mg/dl and/or FPG>126 and/or any of CGM>200. Group 2a: unrecognized glycemic disorder, HbA1c>6.0%. Group 2b: stress hyperglycemia, HbA1c<6.0%. Group 3: Recognized diabetes. Duration of ICU stays, APACHE-II scores were recorded. Logistic regression analysis was performed using ICU stay as dependent variable and age, groups, co-morbidities, problems in hospital, APACHE-II scores, CGMs were used as independent risk factors.

Results: There were 255 (51.6%) in Group 1, 82 (16.6%) in Group 2; 37 (7.5%) cases in Group 2a, 45 (9.1%) in Group 2b and 157 (31.8%) in Group 3. Group 2b spent longer time in ICU, had higher APACHE-II scores (p=0.0001, p=0.0001). Regression analysis demonstrated SH as an independent risk factor for duration of ICU stay (OR: 2.8, 95% CI: 1.3-6.2).

Conclusions: Hyperglycemia was present in 48.4%; 16.6% had NDH, 9.1% had SH. Poor functional conditions of SH cases pointed that they need to be considered carefully.

Trial registration: ClinicalTrials.gov NCT00984737.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Disease / psychology
  • Acute Disease / therapy
  • Aged
  • Blood Glucose / analysis
  • Coronary Disease / blood
  • Coronary Disease / complications*
  • Coronary Disease / psychology
  • Coronary Disease / therapy*
  • Diabetic Cardiomyopathies / blood
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Hospitals, University
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / complications*
  • Hyperglycemia / epidemiology*
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Stress, Psychological / blood
  • Stress, Psychological / complications*
  • Stress, Psychological / epidemiology*
  • Time Factors
  • Turkey / epidemiology

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human

Associated data

  • ClinicalTrials.gov/NCT00984737