[Prediabetes as a riskmarker for stress-induced hyperglycemia in critically ill adults]

Rev Med Inst Mex Seguro Soc. 2017:55 Suppl 1:S14-S19.
[Article in Spanish]


Background: It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia.

Methods: Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5.7 and 6.4%), respectively. We examined the proportion of non-prediabetic and prediabetic patients that developed stress hyperglycemia with contingence tables and Fisher's exact test for nominal scales.

Results: Of 73 patients studied, we found a proportion of stress-induced hyperglycemia in 6.6% in those without prediabetes and 61.1% in those with prediabetes. The Fisher's exact test value was 22.46 (p < 0.05).

Conclusions: Prediabetes is a risk marker for stress-induced hyperglycemia in critically ill adults.

Introducción: no se conoce si los pacientes con prediabetes, un subgrupo de pacientes no diabéticos que generalmente cursan con hiperinsulinemia, tienen mayor riesgo de presentar hiperglucemia inducida por estrés. El objetivo fue determinar si la prediabetes es un marcador de riesgo para presentar hiperglucemia inducida por estrés. Métodos: estudio analítico, observacional, prospectivo de cohorte en pacientes críticos sin antecedentes de diabetes mellitus de un hospital de tercer nivel. Se determinó al ingreso la glucosa plasmática y la hemoglobina glucosilada (HbA1c) para diagnosticar hiperglucemia de estrés (glucosa ≥ 140 mg/dL) y prediabetes (HbA1c entre 5.7 y 6.4%), respectivamente. Se examinó la proporción de pacientes sin prediabetes y prediabéticos que desarrollaron hiperglucemia de estrés con tablas de contingencia y prueba exacta de Fisher para escalas nominales. Resultados: 73 pacientes se estudiaron y se encontró una proporción de hiperglucemia de estrés en pacientes sin prediabetes de 6.6 y 61.1% en los pacientes con prediabetes. La prueba exacta de Fisher dio 22.46 (p < 0.05). Conclusión: la prediabetes es un marcador de riesgo para hiperglucemia de estrés en el paciente adulto críticamente enfermo.

Keywords: Critical illness; Hyperglycemia; Intensive care unit; Physiological stress; Prediabetes.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Critical Illness*
  • Female
  • Humans
  • Hyperglycemia / diagnosis
  • Hyperglycemia / epidemiology
  • Hyperglycemia / etiology*
  • Male
  • Middle Aged
  • Prediabetic State / complications
  • Prediabetic State / diagnosis*
  • Prediabetic State / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Stress, Psychological / complications*
  • Young Adult