Impact of diabetes mellitus and its complications: survival and quality-of-life in critically ill patients

J Diabetes Complications. Nov-Dec 2015;29(8):1130-5. doi: 10.1016/j.jdiacomp.2015.08.010. Epub 2015 Aug 15.

Abstract

Purpose: Diabetes mellitus represents an increasing problem for patients and health care systems worldwide. We sought to investigate the effect of diabetes and its associated comorbidities on long-term survival and quality of life following an admission to a medical intensive care unit (ICU).

Methods: A total of 6662 consecutive patients admitted to ICU between 2004 and 2009 were included (patients with diabetes n=796, non-diabetic patients n=5866). The primary endpoint of the study was death of any cause. Data on mortality was collected upon review of medical records or phone interviews. Moreover, a questionnaire was sent to 500 randomly selected patients addressing Health related Quality of Life (HrQoL) after ICU treatment.

Results: Overall mortality did not differ significantly between diabetic and non-diabetic patients after ICU treatment (mean follow-up time: 490 days). For a subgroup of patients already exhibiting comorbidities associated with diabetes, the mortality rate was significantly higher (p=0.022). Regarding quality of life, no differences were found between groups.

Conclusions: Diabetes was not associated with increased mortality or reduced quality of life in a general population of medical ICU patients. However, once comorbidities associated with diabetes occurred, the survival rate of patients with comorbidities associated with hyperglycemia was significantly reduced.

Keywords: Critically ill; Diabetes mellitus; Follow-up; Intensive care; Quality of life.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cohort Studies
  • Comorbidity
  • Diabetes Complications / epidemiology
  • Diabetes Complications / mortality
  • Diabetes Complications / physiopathology*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / mortality
  • Diabetes Mellitus / physiopathology*
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Hospitals, University
  • Humans
  • Intensive Care Units*
  • Male
  • Medical Records
  • Middle Aged
  • Mortality
  • Quality of Life*
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Tertiary Care Centers