ArticleCritical care (London, England)2011
Mild hypoglycemia is independently associated with increased mortality in the critically ill.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 3 of them syntheses that pooled it.
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Who cites it
73 citing papers in PubMed, 3 syntheses or guidelines pooled it, 179 citations in OpenAlex.
- Effect of liberal glucose control on critically ill patients: a systematic review and meta-analysis.BMC endocrine disorders · 2025Pooled it
- The effect of hypoglycaemia during hospital admission on health-related outcomes for people with diabetes: a systematic review and meta-analysis.Diabetic medicine : a journal of the British Diabetic Association · 2019Pooled it
- Systematic review of incretin therapy during peri-operative and intensive care.Critical care (London, England) · 2018Pooled it
- Composite Metric of Glycemic Control Q-Score Is Elevated in Pediatric and Adolescent/Young Adult Hematopoietic Stem Cell Transplant Recipients.Diabetes technology & therapeutics · 2023Trial
- Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial.Intensive care medicine · 2021Trial
- Severe and multiple hypoglycemic episodes are associated with increased risk of death in ICU patients.Critical care (London, England) · 2015Trial
- Framework for evaluating in vitro vasculogenic mimicry using structural and metabolic parameters.Cell reports methods · 2026Article
- Low estimated glucose disposal rate (eGDR) predicts decreased all-cause mortality in critically ill patients with cardiorenal syndrome (CRS): analysis of the MIMIC-IV database.Scientific reports · 2025Article
- Article
- Flash Glucose Monitoring for Predicting Cardiogenic Shock Occurrence in Critically Ill Patients: A Retrospective Pilot Study.Diagnostics (Basel, Switzerland) · 2025Article
- 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
- Incidence and outcomes of early hyperglycaemia in critically ill patients.The Southern African journal of critical care : the official journal of the Critical Care Society · 2025Article
- Estimating risk of consequences following hypoglycaemia exposure using the Hypo-RESOLVE cohort: a secondary analysis of pooled data from insulin clinical trials.Diabetologia · 2024Article
- Hypoglycemia in non-diabetic in-patients at a teaching referral hospital in Iran.Journal of diabetes and metabolic disorders · 2024Article
- GLUCOSE AND SODIUM LEVELS AS DISEASE OUTCOME PREDICTORS IN CRITICALLY ILL PATIENTS.Acta clinica Croatica · 2023Article
- Prognostic Value of Serum Glucose Level in Critically Ill Septic Patients on Admission to Pediatric Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Perioperative glycemic management in adults presenting for elective cardiac and non-cardiac surgery.Perioperative medicine (London, England) · 2023Review
- Article
- Expert consensus on the glycemic management of critically ill patients.Journal of intensive medicine · 2022Article
- Relative Hypoglycemia is Associated with Delirium in Critically Ill Patients with Diabetes: A Cohort Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSevere hypoglycemia (blood glucose concentration (BG) < 40 mg/dL) is independently associated with an increased risk of mortality in critically ill patients. The association of milder hypoglycemia (BG < 70 mg/dL) with mortality is less clear.
methodsProspectively collected data from two observational cohorts in the USA and in The Netherlands, and from the prospective GLUCONTROL trial were analyzed. Hospital mortality was the primary endpoint.
resultsWe analyzed data from 6,240 patients: 3,263 admitted to Stamford Hospital (ST), 2,063 admitted to three institutions in The Netherlands (NL) and 914 who participated in the GLUCONTROL trial (GL). The percentage of patients with hypoglycemia varied from 18% to 65% among the different cohorts. Patients with hypoglycemia experienced higher mortality than did those without hypoglycemia even after stratification by severity of illness, diagnostic category, diabetic status, mean BG during intensive care unit (ICU) admission and coefficient of variation (CV) as a reflection of glycemic variability. The relative risk (RR, 95% confidence interval) of mortality associated with minimum BG < 40, 40 to 54 and 55 to 69 mg/dL compared to patients with minimum BG 80 to 109 mg/dL was 3.55 (3.02 to 4.17), 2.70 (2.31 to 3.14) and 2.18 (1.87 to 2.53), respectively (all P < 0.0001). The RR of mortality associated with any hypoglycemia < 70 mg/dL was 3.28 (2.78 to 3.87) (P < 0.0001), 1.30 (1.12 to 1.50) (P = 0.0005) and 2.11 (1.62 to 2.74) (P < 0.0001) for the ST, NL and GL cohorts, respectively. Multivariate regression analysis demonstrated that minimum BG < 70 mg/dL, 40 to 69 mg/dL and < 40 mg/dL were independently associated with increased risk of mortality for the entire cohort of 6,240 patients (odds ratio (OR) (95% confidence interval (CI)) 1.78 (1.39 to 2.27) P < 0.0001), 1.29 (1.11 to 1.51) P = 0.0011 and 1.87 (1.46 to 2.40) P < 0.0001) respectively.
conclusionsMild hypoglycemia was associated with a significantly increased risk of mortality in an international cohort of critically ill patients. Efforts to reduce the occurrence of hypoglycemia in critically ill patients may reduce mortality.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.