Higher glucose variability in type 1 than in type 2 diabetes patients admitted to the intensive care unit: A retrospective cohort study

J Crit Care. 2017 Apr:38:300-303. doi: 10.1016/j.jcrc.2016.12.021. Epub 2016 Dec 29.

Abstract

Purpose: Although the course of disease of type 1 and type 2 diabetes differs, the distinction is rarely made when patients are admitted to the intensive care unit (ICU). Here, we report patient- and admission-related characteristics in relation to glycemic measures of patients with type 1 and type 2 diabetes admitted to the ICU.

Materials and methods: A retrospective chart review was performed of 1574 patients with diabetes admitted between 2004 and 2011 to our ICU. Glycemic measures included mean glucose, the incidence of hypoglycemia and hyperglycemia, percentage of glucose values in/below/above target, and glucose variability. The ICU and hospital mortality were secondary outcomes.

Results: We classified 2% (n=27) of patients as having type 1 diabetes and 98% (n=1547) as having type 2 diabetes. Patients with type 1 diabetes were significantly younger, had a lower body mass index, and were more frequently admitted to the ICU for medical diagnoses. No differences in glycemic measures were found, apart from a 20% higher glucose variability in the type 1 diabetes group.

Conclusions: Patients with type 1 diabetes showed a higher glucose variability, but overall glycemic control was not different between patients with type 1 and type 2 diabetes. Very few diabetes patients admitted to the ICU have type 1 diabetes.

Keywords: Diabetes mellitus type 1; Diabetes mellitus type 2; Glucose regulation; Glycemic control; Mortality.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Glucose / metabolism*
  • Critical Illness*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Hyperglycemia / epidemiology
  • Hyperglycemia / metabolism*
  • Hypoglycemia / epidemiology
  • Hypoglycemia / metabolism*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Intensive Care Units
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin