Observational studyIntensive care medicine2016
Pre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality.
Observational study in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- 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
- Dysglycaemia and the interaction of chronic and acute glycaemia with mortality post cardiac surgery.Scientific reports · 2025Article
- Analysis of Factors Associated with Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest Undergoing Targeted Temperature Management.Journal of clinical medicine · 2025Article
- Impact of Glucagon-Like Peptide-1 Receptor Agonist Exposure on Gastrointestinal Outcomes Among ICU Patients: A Multicenter Matched Cohort Study.Critical care explorations · 2025Article
- Hypoglycemia and hospital mortality in critically ill patients.Scientific reports · 2025Article
- The Value of Glycemic Gap for Predicting Mortality in ICU in Patients With and Without Diabetes.Journal of diabetes research · 2025Article
- Triglyceride-lowering therapies in hypertriglyceridemia-associated acute pancreatitis in China: a multicentre prospective cohort study.BMC medicine · 2024Article
- Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China.Journal of intensive medicine · 2024Article
- The relationship between hyperglycaemia on admission and patient outcome is modified by hyperlactatemia and diabetic status: a retrospective analysis of the eICU collaborative research database.Scientific reports · 2023Article
- Stress hyperglycemia ratio is associated with systemic inflammation and clinical outcomes in diabetic inpatients with pneumonia on admission.Journal of diabetes · 2023Article
- Sodium glucose co-transporter-2 inhibitors in intensive care unit patients with type 2 diabetes: a pilot case control study.Critical care (London, England) · 2023Article
- Acute and Chronic Glucose Control in Critically Ill Patients With Diabetes: The Impact of Prior Insulin Treatment.Journal of diabetes science and technology · 2022Observational
- Association of time in range with postoperative wound healing in patients with diabetic foot ulcers.International wound journal · 2022Article
- The Optimal Glycemic Control in Patients with Diabetes in the ICU: Where Is the Sweet Spot?American journal of respiratory and critical care medicine · 2022Article
- Association between time in range of relative normoglycemia and in-hospital mortality in critically ill patients: a single-center retrospective study.Scientific reports · 2022Article
- Expert consensus on the glycemic management of critically ill patients.Journal of intensive medicine · 2022Article
- Impact of prolonged requirement for insulin on 90-day mortality in critically ill patients without previous diabetic treatments: a post hoc analysis of the CONTROLING randomized control trial.Critical care (London, England) · 2022Article
- Association between dysglycemia and mortality by diabetes status and risk factors of dysglycemia in critically ill patients: a retrospective study.Acta diabetologica · 2022Article
- Effect of glycemic gap upon mortality in critically ill patients with diabetes.Journal of diabetes investigation · 2021Observational
- Blood Sugar Targets in Surgical Intensive Care—Management and Special Considerations in Patients With DiabetesDeutsches Arzteblatt international · 2021Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo study the impact of pre-morbid glycemic control on the association between acute hypoglycemia in intensive care unit (ICU) patients and subsequent hospital mortality in critically ill patients.
methodsWe performed a multicenter, multinational, retrospective observational study of patients with available HbA1c levels within the 3-month period preceding ICU admission. We separated patients into three cohorts according to pre-admission HbA1c levels (<6.5, 6.5-7.9, ≥8.0%, respectively). Based on published data, we defined a glucose concentration of 40-69 mg/dL (2.2-3.8 mmol/L) as moderate hypoglycemia and <40 mg/dL (<2.2 mmol/L) as severe hypoglycemia. We applied logistic regression analysis to study the impact of pre-morbid glycemic control on the relationship between acute hypoglycemia and mortality.
resultsA total of 3084 critically ill patients were enrolled in the study. Among these patients, with increasing HbA1c levels from <6.5, to 6.5-7.9, and to ≥8.0%, the incidence of both moderate (3.8, 11.1, and 16.4%, respectively; p < 0.001) and severe (0.9, 2.5, and 4.3%, respectively; p < 0.001) hypoglycemia progressively and significantly increased. The relationship between the occurrence of hypoglycemic episodes in the ICU and in-hospital mortality was independently and significantly affected by pre-morbid glucose control, as assessed by adjusted odds ratio (OR) and 95 % confidence interval (CI) for hospital mortality: (1) moderate hypoglycemia: in patients with <6.5, 6.5-7.9, and ≥8.0 % of HbA1c level-OR 0.54, 95% CI 0.25-1.16; OR 0.82, 95 % CI 0.33-2.05; OR 3.42, 95 % CI 1.29-9.06, respectively; (2) severe hypoglycemia: OR 1.50, 95% CI 0.42-5.33; OR 1.59, 95% CI 0.36-7.10; OR 23.46, 95% CI 5.13-107.28, respectively (interaction with pre-morbid glucose control, p = 0.009). We found that the higher the glucose level before admission to the ICU, the higher the mortality risk when patients experienced hypoglycemia.
conclusionsIn critically ill patients, chronic pre-morbid hyperglycemia increases the risk of hypoglycemia and modifies the association between acute hypoglycemia and mortality.
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