Hypoglycemia and Mortality in Critically Ill Patients with Type 2 Diabetes

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F20%3A10410844" target="_blank" >RIV/00216208:11130/20:10410844 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064203:_____/20:10410844

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=92ToYCLLv4" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=92ToYCLLv4</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1159/000503033" target="_blank" >10.1159/000503033</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Hypoglycemia and Mortality in Critically Ill Patients with Type 2 Diabetes

Popis výsledku v původním jazyce

The article by Wernly et al. entitled &quot;Hypoglycemia but not hyperglycemia is associated with mortality in critically ill patients with diabetes&quot; reports on the association between a single episode of blood glucose deviation during an intensive care unit stay with mortality in critically ill patients, including those with type 2 diabetes mellitus (T2DM). The authors concluded that in patients with T2DM, hypoglycemia but not hyperglycemia was associated with increased mortality, whereas in patients without diabetes, both hyper- and hypoglycemia were associated with adverse outcomes. We would like to comment on the definition of hypoglycemia used in the study. The authors correctly used values &lt;=70 mg/dL as a threshold for hypoglycemia. However, this level is generally considered as an &quot;alert value&quot; to trigger individual patients to take appropriate steps to increase glucose concentration. A value of &lt;54 mg/dL has been factored into the definition of hypoglycemia to determine &quot;clinically significant&quot; hypoglycemia, and this level can be taken to indicate the onset of significant neuroglycopenia in patients with diabetes. In patients with T2DM, a decrease in glucose concentration below this level is associated with cardiac arrhythmias and increased mortality. We suggest that this point be taken into consideration if the authors plan to continue their study; we recommend analyzing glycemic data separately for values between levels &lt;=70 and 54 mg/dL as well as &lt;54 mg/dL, at least in T2DM patients. We believe that this could provide further insights into the relationship between hypoglycemia and mortality, and could be important for the clinical approach regarding maintenance of glycemia in critically ill T2DM patients.

Název v anglickém jazyce

Hypoglycemia and Mortality in Critically Ill Patients with Type 2 Diabetes

Popis výsledku anglicky

The article by Wernly et al. entitled &quot;Hypoglycemia but not hyperglycemia is associated with mortality in critically ill patients with diabetes&quot; reports on the association between a single episode of blood glucose deviation during an intensive care unit stay with mortality in critically ill patients, including those with type 2 diabetes mellitus (T2DM). The authors concluded that in patients with T2DM, hypoglycemia but not hyperglycemia was associated with increased mortality, whereas in patients without diabetes, both hyper- and hypoglycemia were associated with adverse outcomes. We would like to comment on the definition of hypoglycemia used in the study. The authors correctly used values &lt;=70 mg/dL as a threshold for hypoglycemia. However, this level is generally considered as an &quot;alert value&quot; to trigger individual patients to take appropriate steps to increase glucose concentration. A value of &lt;54 mg/dL has been factored into the definition of hypoglycemia to determine &quot;clinically significant&quot; hypoglycemia, and this level can be taken to indicate the onset of significant neuroglycopenia in patients with diabetes. In patients with T2DM, a decrease in glucose concentration below this level is associated with cardiac arrhythmias and increased mortality. We suggest that this point be taken into consideration if the authors plan to continue their study; we recommend analyzing glycemic data separately for values between levels &lt;=70 and 54 mg/dL as well as &lt;54 mg/dL, at least in T2DM patients. We believe that this could provide further insights into the relationship between hypoglycemia and mortality, and could be important for the clinical approach regarding maintenance of glycemia in critically ill T2DM patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Medical Principles and Practice

ISSN

1011-7571

e-ISSN

—

Svazek periodika

29

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

KW - Kuvajtský stát

Počet stran výsledku

1

Strana od-do

99

Kód UT WoS článku

000513157200017

EID výsledku v databázi Scopus

2-s2.0-85073096373