ArticleCritical care (London, England)2014
Coefficient of glucose variation is independently associated with mortality in critically ill patients receiving intravenous insulin.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Predictive value of different glycemic variability indicators for prognosis in critically ill patients: a meta-analysis.Frontiers in endocrinology · 2026Pooled 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
- Preoperative Carbohydrate Drink Intake Increases Glycemic Variability in Patients with Type 2 Diabetes Mellitus in Total Joint Arthroplasty: A Prospective Randomized Trial.World journal of surgery · 2022Trial
- Individualising blood glucose control in ICU patients: evidence and practical implementations.Critical care (London, England) · 2026Review
- Glucose Management in the ICU: The Bi-Centre GEM-ICU Cohort Study.Acta anaesthesiologica Scandinavica · 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
- Association of glycemic variability with short- and long-term mortality in critically ill patients with trauma.Scientific reports · 2025Article
- Predictive value of glucose coefficient of variation for in-hospital mortality in acute myocardial infarction patients undergoing PCI: Insights from the MIMIC-IV database.International journal of cardiology. Cardiovascular risk and prevention · 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
- Screening for Impaired Glucose Homeostasis: A Novel Metric of Glycemic Control.Mayo Clinic proceedings. Digital health · 2023Article
- What, why and how to monitor blood glucose in critically ill patients.World journal of diabetes · 2023Review
- Expert consensus on the glycemic management of critically ill patients.Journal of intensive medicine · 2022Article
- Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure.Journal of clinical medicine · 2022Article
- Article
- Effect of high-protein vs. high-fat snacks before lunch on glycemic variability in prediabetes: A study protocol for a randomized controlled trial.Frontiers in nutrition · 2022Article
- Enabling a learning healthcare system with automated computer protocols that produce replicable and personalized clinician actions.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Identifying Glycemic Variability in Diabetes Patient Cohorts and Evaluating Disease Outcomes.Journal of clinical medicine · 2021Article
- Impact of Comorbidities on Beneficial Effect of Lactated Ringers vs. Saline in Sepsis Patients.Frontiers in medicine · 2021Article
- Glycemic variability: adverse clinical outcomes and how to improve it?Cardiovascular diabetology · 2020Review
- Dynamic properties of glucose complexity during the course of critical illness: a pilot study.Journal of clinical monitoring and computing · 2020Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
introductionBoth patient- and context-specific factors may explain the conflicting evidence regarding glucose control in critically ill patients. Blood glucose variability appears to correlate with mortality, but this variability may be an indicator of disease severity, rather than an independent predictor of mortality. We assessed blood glucose coefficient of variation as an independent predictor of mortality in the critically ill.
methodsWe used eProtocol-Insulin, an electronic protocol for managing intravenous insulin with explicit rules, high clinician compliance, and reproducibility. We studied critically ill patients from eight hospitals, excluding patients with diabetic ketoacidosis and patients supported with eProtocol-insulin for < 24 hours or with < 10 glucose measurements. Our primary clinical outcome was 30-day all-cause mortality. We performed multivariable logistic regression, with covariates of age, gender, glucose coefficient of variation (standard deviation/mean), Charlson comorbidity score, acute physiology score, presence of diabetes, and occurrence of hypoglycemia < 60 mg/dL.
resultsWe studied 6101 critically ill adults. Coefficient of variation was independently associated with 30-day mortality (odds ratio 1.23 for every 10% increase, P < 0.001), even after adjustment for hypoglycemia, age, disease severity, and comorbidities. The association was higher in non-diabetics (OR = 1.37, P < 0.001) than in diabetics (OR 1.15, P = 0.001).
conclusionsBlood glucose variability is associated with mortality and is independent of hypoglycemia, disease severity, and comorbidities. Future studies should evaluate blood glucose variability.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.