ArticleAnnals of intensive care2020
Higher glycemic variability within the first day of ICU admission is associated with increased 30-day mortality in ICU patients with sepsis.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
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51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 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
- Which is better for glycemic control? bolus, intermittent (nocturnal pause) or continuous enteral feeding in septic critically ill patients.Science progressTrial
- Predictive value of stress-induced hyperglycemia for 28-day all-cause mortality in ICU patients with sepsis: a MIMIC-IV-based retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- A Pilot Study on the Evaluation of an Inpatient Glycaemic Management Protocol for Enteral Feeding in People with Diabetes.Diseases (Basel, Switzerland) · 2026Article
- Blood Glucose Trajectories and Mortality in Sepsis-Induced Coagulopathy: A Latent Growth Mixture Modeling Analysis.Shock (Augusta, Ga.) · 2026Article
- Association of glycemic variability with 28-day mortality and adverse outcomes among non-diabetes patients after cardiac surgery with cardiopulmonary bypass: a retrospective analysis on the MIMIC-IV database.BMC endocrine disorders · 2026Article
- How glycemic variability trajectories impact clinical outcomes in critically ill patients with severe pneumonia: a prospective cohort study.BMC anesthesiology · 2026Article
- Coefficient of variation-defined glycemic variability is associated with ICU mortality in critically ill influenza patients.BMC infectious diseases · 2026Article
- Association between glycemic variability and all-cause mortality in patients with sepsis-associated acute respiratory distress syndrome: a retrospective study based on the MIMIC database.Journal of thoracic disease · 2026Article
- Glycemic Variability as a Predictor of Mortality in Sepsis Patients With Concurrent Persistent Inflammation, Immunosuppression, and Catabolism Syndrome.Immunity, inflammation and disease · 2026Article
- Integrating Admission Hyperglycemia Into Multidisciplinary Risk Stratification for Sepsis in the ICU: A Retrospective Cohort Study.Journal of multidisciplinary healthcare · 2026Article
- Hemoglobin glycation index and short-term mortality in sepsis: a retrospective cohort study with external validation.Frontiers in medicine · 2026Article
- Association of glycemic variability with short- and long-term mortality in critically ill patients with trauma.Scientific reports · 2025Article
- From glycemic variability to digital signal biomarker: a prognostic and precision medicine framework for sepsis-associated acute kidney injury.Renal failure · 2025Article
- Prognostic significance of postoperative glycemic variability after gastric surgery: a retrospective cohort study and development of a mortality prediction model.European journal of medical research · 2025Article
- The Association Between Dysglycemia and Endotheliopathy in ICU Patients With and Without Diabetes: A Cohort Study.Critical care explorations · 2025Observational
- Association between various blood glucose variability-related indicators during early ICU admission and 28-day mortality in non-diabetic patients with sepsis.Diabetology & metabolic syndrome · 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
- Identification of novel phenotypes in pediatric sepsis based on blood glucose trajectories.Frontiers in pediatrics · 2025Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHigh glycemic variability (GV) is common in critically ill patients; however, the prevalence and mortality association with early GV in patients with sepsis remains unclear.
methodsThis retrospective cohort study was conducted in a medical intensive care unit (ICU) in central Taiwan. Patients in the ICU with sepsis between January 2014 and December 2015 were included for analysis. All of these patients received protocol-based management, including blood sugar monitoring every 2 h for the first 24 h of ICU admission. Mean amplitude of glycemic excursions (MAGE) and coefficient of variation (CoV) were used to assess GV.
resultsA total of 452 patients (mean age 71.4 ± 14.7 years; 76.7% men) were enrolled for analysis. They were divided into high GV (43.4%, 196/452) and low GV (56.6%, 256/512) groups using MAGE 65 mg/dL as the cut-off point. Patients with high GV tended to have higher HbA1c (6.7 ± 1.8% vs. 5.9 ± 0.9%, p < 0.01) and were more likely to have diabetes mellitus (DM) (50.0% vs. 23.4%, p < 0.01) compared with those in the low GV group. Kaplan-Meier analysis showed that a high GV was associated with increased 30-day mortality (log-rank test, p = 0.018). The association remained strong in the non-DM (log-rank test, p = 0.035), but not in the DM (log-rank test, p = 0.254) group. Multivariate Cox proportional hazard regression analysis identified that high APACHE II score (adjusted hazard ratio (aHR) 1.045, 95% confidence interval (CI) 1.013-1.078), high serum lactate level at 0 h (aHR 1.009, 95% CI 1.003-1.014), having chronic airway disease (aHR 0.478, 95% CI 0.302-0.756), high mean day 1 glucose (aHR 1.008, 95% CI 1.000-1.016), and high MAGE (aHR 1.607, 95% CI 1.008-2.563) were independently associated with increased 30-day mortality. The association with 30-day mortality remained consistent when using CoV to assess GV.
conclusionsWe found that approximately 40% of the septic patients had a high early GV, defined as MAGE > 65 mg/dL. Higher GV within 24 h of ICU admission was independently associated with increased 30-day mortality. These findings highlight the need to monitor GV in septic patients early during an ICU admission.
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