ArticleCritical care (London, England)2008
The impact of the severity of sepsis on the risk of hypoglycaemia and glycaemic variability.
Article in Critical care (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- Is intensive glucose control bad for critically ill patients? A systematic review and meta-analysis.International journal of biological sciences · 2020Pooled it
- Intensive insulin therapy for septic patients: a meta-analysis of randomized controlled trials.BioMed research international · 2014Pooled it
- Glucose variability measures and their effect on mortality: a systematic review.Intensive care medicine · 2011Pooled it
- Glycemic variability and glucose complexity in critically ill patients: a retrospective analysis of continuous glucose monitoring data.Critical care (London, England) · 2012Trial
- Decision support for optimized blood glucose control and nutrition in a neurotrauma intensive care unit: preliminary results of clinical advice and prediction accuracy of the Glucosafe system.Journal of clinical monitoring and computing · 2012Trial
- Glycemic variability improves risk prediction and reveals a mortality threshold in orthopedic trauma patients with sepsis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026Article
- Association of Glycemic Variability with Outcomes in Non-diabetic Sepsis Patients: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Identifying early blood glucose trajectories in sepsis linked to distinct long-term outcomes: a K-means clustering study with external validation.Frontiers in immunology · 2025Article
- Noniatrogenic hypoglycemia: A universal marker for poor outcomes.JTCVS open · 2024Article
- Estimating Enhanced Endogenous Glucose Production in Intensive Care Unit Patients with Severe Insulin Resistance.Journal of diabetes science and technology · 2022Article
- Acute glycemic variability and risk of mortality in patients with sepsis: a meta-analysis.Diabetology & metabolic syndrome · 2022Article
- Association of Blood Glucose Variability with Sepsis-Related Disseminated Intravascular Coagulation Morbidity and Mortality.Journal of inflammation research · 2022Article
- Application of Peak Glucose Range and Diabetes Status in Mortality Risk Stratification in Critically Ill Patients with Sepsis.Diagnostics (Basel, Switzerland) · 2021Article
- Association of sleep quality with glycemic variability assessed by flash glucose monitoring in patients with type 2 diabetes.Diabetology & metabolic syndrome · 2021Article
- The Association of Low Blood Glucose and Low Serum Cortisol Levels in Severely Ill Children Admitted to Tertiary Referral Hospitals in Malawi: A Case-Control Study.The American journal of tropical medicine and hygiene · 2021Article
- Insulin sensitivity in critically ill patients: are women more insulin resistant?Annals of intensive care · 2021Article
- Admission Blood Glucose Is Associated With the 30-Days Mortality in Septic Patients: A Retrospective Cohort Study.Frontiers in medicine · 2021Article
- GLP-1 Receptor: A New Target for Sepsis.Frontiers in pharmacology · 2021Review
- Therapeutic Effects of Endogenous Incretin Hormones and Exogenous Incretin-Based Medications in Sepsis.The Journal of clinical endocrinology and metabolism · 2019Review
- Impact of drugs on hypoglycaemia in hospitalised patients.European journal of hospital pharmacy : science and practice · 2019Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe purpose of this study was to assess the relation between glycaemic control and the severity of sepsis in a cohort of patients treated with intensive insulin therapy (IIT).
methodsIn a prospective, observational study, all patients in the intensive care unit (ICU) (n = 191) with sepsis, severe sepsis or septic shock were treated with IIT (target blood glucose (BG) level 80 to 140 mg/dl instead of strict normoglycaemia). BG values were analysed by calculating mean values, rate of BG values within different ranges, rate of patients experiencing BG values within different levels and standard deviation (SD) of BG values as an index of glycaemic variability.
resultsThe number of patients with hypoglycaemia and hyperglycaemia was highly dependent on the severity of sepsis (critical hypoglycaemia < or = 40 mg/dl: sepsis: 2.1%, severe sepsis: 6.0%, septic shock: 11.5%, p = 0.1497; hyperglycaemia: >140 mg/dl: sepsis: 76.6%, severe sepsis: 88.0%, septic shock: 100%, p = 0.0006; >179 mg/dl: sepsis: 55.3%, severe sepsis: 73.5%, septic shock: 88.5%, p = 0.0005; >240 mg/dl: sepsis: 17.0%, severe sepsis: 48.2%, septic shock: 45.9%, p = 0.0011). Multivariate analyses showed a significant association of SD levels with critical hypoglycaemia especially for patients in septic shock (p = 0.0197). In addition, SD levels above 20 mg/dl were associated with a significantly higher mortality rate relative to those with SD levels below 20 mg/dl (24% versus 2.5%, p = 0.0195).
conclusionsPatients with severe sepsis and septic shock who were given IIT had a high risk of hypoglycaemia and hyperglycaemia. Among these patients even with a higher target BG level, IIT mandates an increased awareness of the occurrence of critical hypoglycaemia, which is related to the severity of the septic episode.
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