ArticleCritical care (London, England)2021
The obesity paradox and hypoglycemia in critically ill patients.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 38 citations in OpenAlex.
- Cardiac autonomic neuropathy modified the association between obesity and hypoglycemia in type 2 diabetes.Endocrine · 2024Trial
- Prehabilitation for Pressure Ulcer Surgery: A Practical and Evidence-based Guide.Plastic and reconstructive surgery. Global open · 2026Article
- Heterogeneity of Treatment Effects Across Nine Glucose-Lowering Drug Classes in Type 2 Diabetes: Extension of the LEGEND-T2DM Network Study.Diabetes, obesity & metabolism · 2026Observational
- Gaps or paradoxes in clinical responses in obese patients.Intensive care medicine · 2026Article
- Heterogeneity of Treatment Effects Across Nine Glucose-Lowering Drug Classes in Type 2 Diabetes: Extension of the LEGEND-T2DM Network Study.medRxiv : the preprint server for health sciences · 2026Article
- Risk Factors for Hypoglycemia in Type 2 Diabetes Mellitus Patients Using Once-Weekly Semaglutide: A Matched Case-Control Study.Therapeutics and clinical risk management · 2026Article
- Preoperative machine learning algorithm for predicting urosepsis after percutaneous nephrolithotomy using EMR data.Urolithiasis · 2025Article
- Analysis of Factors Associated with Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest Undergoing Targeted Temperature Management.Journal of clinical medicine · 2025Article
- The flux of energy in critical illness and the obesity paradox.Physiological reviews · 2025Review
- Association between triglyceride glucose body mass index and 1 year all cause mortality in stage 4 CKM syndrome patients.Scientific reports · 2025Article
- The obesity paradox and 90 day mortality in chronic critically ill patients: a cohort study using a large clinical database.European journal of medical research · 2024Article
- Joint effect of atrial fibrillation and obesity on mortality in critically ill patients.Diabetology & metabolic syndrome · 2024Article
- Adaptive Metabolic Responses Facilitate Blood-Brain Barrier Repair in Ischemic Stroke via BHB-Mediated Epigenetic Modification of ZO-1 Expression.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2024Article
- Bilirubin influences the predictive effect of body mass index on hospital mortality in critically ill patients.Heliyon · 2024Article
- Development and validation of a prediction model for self-reported hypoglycemia risk in patients with type 2 diabetes: A longitudinal cohort study.Journal of diabetes investigation · 2024Article
- The impact of body mass index on long-term survival after ICU admission due to COVID-19: A retrospective multicentre study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- The paradox of obesity in pressure ulcers of critically ill patients.International wound journal · 2023Article
- Findings for iGlarLixi versus BIAsp 30 confirmed in groups of people with type 2 diabetes with different biomedical characteristics.Diabetes, obesity & metabolism · 2023Article
- Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease.Frontiers in cardiovascular medicine · 2023Article
- BMI Modifies Increased Mortality Risk of Post-PCI STEMI Patients with AKI.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA high body mass index (BMI) has been associated with decreased mortality in critically ill patients. This association may, in part, relate to the impact of BMI on glycemia. We aimed to study the relationship between BMI, glycemia and hospital mortality.
methodsWe included all patients with a recorded BMI from four large international clinical databases (n = 259,177). We investigated the unadjusted association of BMI with average glucose levels, mortality and hypoglycemia rate. We applied multivariate analysis to investigate the impact of BMI on hypoglycemia rate, after adjusting for glycemia-relevant treatments (insulin, dextrose, corticosteroids, enteral and parenteral nutrition) and key physiological parameters (previous blood glucose level, blood lactate, shock state, SOFA score).
resultsWe analyzed 5,544,366 glucose measurements. On unadjusted analysis, increasing BMI was associated with increasing glucose levels (average increase of 5 and 10 mg/dL for the 25-30, 30-35 kg/m
conclusionsIncreasing BMI is independently associated with decreased risk of hypoglycemia. It is also associated with increasing hyperglycemia and yet with lower mortality. Lower risk of hypoglycemia might contribute to decreased mortality and might partly explain the obesity paradox. These associations, however, were markedly modified by the presence of diabetes.
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