ArticleCritical care (London, England)2013
The effect of diabetes mellitus on the association between measures of glycaemic control and ICU mortality: a retrospective cohort study.
Article in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 4 of them syntheses that pooled it.
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Who cites it
63 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Short-term glycemic variability and the risk of adverse ICU outcomes in critically ill patients: a systematic review and meta-analysis.Frontiers in nutrition · 2026Pooled it
- Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled 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
- Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis.Critical care (London, England) · 2018Pooled it
- Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial.Intensive care medicine · 2021Trial
- Individualising blood glucose control in ICU patients: evidence and practical implementations.Critical care (London, England) · 2026Review
- Association of mean blood glucose, glycemic variability, and their combined effect with 28-day mortality in critically ill ICU patients with acute myocardial infarction: a MIMIC-IV retrospective cohort study.Journal of thoracic disease · 2026Article
- Diabetes Mellitus Is an Independent Predictor of Short-Term Mortality in Critically Ill ICU Patients.Healthcare (Basel, Switzerland) · 2026Article
- Simultaneous assessment of stress hyperglycemia ratio and glucose variability to predict all-cause mortality in sepsis patients across different glucose metabolic states: an observational cohort study with interpretable machine learning approach.International journal of surgery (London, England) · 2026Observational
- The additive effect of hemoglobin glycation index and glycemic variability to predict mortality in cardiac intensive care patients with and without diabetes.Scientific reports · 2025Article
- Joint impact of stress hyperglycaemic ratio and glycaemic variability in patients with ischaemic stroke and machine learning for mortality prediction.BMC neurology · 2025Article
- Multidrug-Resistant Infections and Metabolic Syndrome: An Overlooked Bidirectional Relationship.Biomedicines · 2025Review
- Risk analysis and mediation analysis of stress hyperglycemia ratio and all-cause mortality in patients with acute kidney injury.Diabetology & metabolic syndrome · 2025Article
- The Value of Glycemic Gap for Predicting Mortality in ICU in Patients With and Without Diabetes.Journal of diabetes research · 2025Article
- The relationship between blood glucose and clinical outcomes after extracorporeal circulation: a retrospective cohort study.Frontiers in cardiovascular medicine · 2025Article
- The association between acute kidney injury and dysglycaemia in critically ill patients with and without diabetes mellitus: a retrospective single-center study.Renal failure · 2024Article
- The Glycemic Ratio Is Strongly and Independently Associated With Mortality in the Critically Ill.Journal of diabetes science and technology · 2024Article
- Relationship between time-weighted average glucose and mortality in critically ill patients: a retrospective analysis of the MIMIC-IV database.Scientific reports · 2024Article
- Simultaneous assessment of stress hyperglycemia ratio and glycemic variability to predict mortality in patients with coronary artery disease: a retrospective cohort study from the MIMIC-IV database.Cardiovascular diabetology · 2024Article
- Glycemic Variability As a Prognostic Factor for Mortality in Patients With Critical Illness: A Systematic Review and Meta-Analysis.Critical care explorations · 2024Review
3 more citing papers are in PubMed but not listed here.
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionIn critical illness, four measures of glycaemic control are associated with ICU mortality: mean glucose concentration, glucose variability, the incidence of hypoglycaemia (≤2.2 mmol/l) or low glucose (2.3 to 4.7 mmol/l). Underlying diabetes mellitus (DM) might affect these associations. Our objective was to study whether the association between these measures of glycaemic control and ICU mortality differs between patients without and with DM and to explore the cutoff value for detrimental low glucose in both cohorts.
methodsThis retrospective database cohort study included patients admitted between January 2004 and June 2011 to a 24-bed medical/surgical ICU in a teaching hospital. We analysed glucose and outcome data from 10,320 patients: 8,682 without DM and 1,638 with DM. The cohorts were subdivided into quintiles of mean glucose and quartiles of glucose variability. Multivariable regression models were used to examine the independent association between the four measures of glycaemic control and ICU mortality, and for defining the cutoff value for detrimental low glucose.
resultsRegarding mean glucose, a U-shaped relation was observed in the non-DM cohort with an increased ICU mortality in the lowest and highest glucose quintiles (odds ratio=1.4 and 1.8, P<0.001). No clear pattern was found in the DM cohort. Glucose variability was related to ICU mortality only in the non-DM cohort, with highest ICU mortality in the upper variability quartile (odds ratio=1.7, P<0.001). Hypoglycaemia was associated with ICU mortality in both cohorts (odds ratio non-DM=2.5, P<0.001; odds ratio DM=4.2, P=0.001), while low-glucose concentrations up to 4.9 mmol/l were associated with an increased risk of ICU mortality in the non-DM cohort and up to 3.5 mmol/l in the DM cohort.
conclusionMean glucose and high glucose variability are related to ICU mortality in the non-DM cohort but not in the DM cohort. Hypoglycaemia (≤2.2 mmol/l) was associated with ICU mortality in both. The cutoff value for detrimental low glucose is higher in the non-DM cohort (4.9 mmol/l) than in the DM cohort (3.5 mmol/l). While hypoglycaemia (≤2.2 mmol/l) should be avoided in both groups, DM patients seem to tolerate a wider glucose range than non-DM patients.
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