Table 7.
Observational studies and outcomes related to hypoglycaemia (chronological order)
Ref. | Year | Study pts | Study point | Non diabetic patients | Diabetic patients | Overall message |
Krinsley and Grover[60] | 2007 | 408 | Risk factors for developing hypoglycaemia in ICU and outcomes | Severe hypoglycaemia associated with septic shock. Renal insufficiency, mechanical ventilation, illness severity and use of ITT | Associated with inc risk of severe hypoglycaemia (P < 0.01)DM had no association with mortality | Mortality in severe hypoglycaemia cohort 56% vs control cohort 40%, P < 0.01 |
Egi et al[61] | 2010 | 4946 | Hypoglycaemia vs risk of death in critically ill patients | Mild or moderate hypoglycaemia was associated with mortality in critically ill patientsMortality increases as severity of hypoglycaemia increases | Diabetic patients more likely to suffer from insulin-associated hypoglycaemia | 22% of total patients had one episode of hypoglycaemiaHospital mortality: hypoglycaemic cohort 37% vs control cohort 20%, P < 0.01 |
Krinsely et al[33] | 2011 | 62401 | Mild hypoglycaemia (blood glucose level < 3.9 mmol/L) vs risk of mortality in critically ill patients. | Mild hypoglycaemia was associated with a significantly increased risk of mortality | The association between hypoglycaemia and mortality was independent of diabetic status | Inc severity of hypoglycaemia was associated with inc risk of mortalityHypoglycemic patients had higher mortality regardless of diagnostic category and ICU LOS |
Krinsley et al[32] | 2013 | 44964 | Hyperglycaemia, hypoglycaemia, and glycemic variability vs mortality (and how DM effects this) | Inc mortality with higher mean blood glucose (≥ 7.8 mmol/L)Dec mortality with lower blood glucose (4.4-7.8 mmol/L) | Inc mortality with mean blood glucose between 4.4-6.1 mmol/LDec mortality when blood glucose were higher (6.2-10 mmol/L) | Hyperglycaemia, hypoglycaemia, and increased glycemic variability are independently associated with mortality in ICU patientsDiabetic status tempers these relations |
Contains partial data from one prospective RCT (Glucontrol trial) and complete data from two observational cohorts (United States and The Netherlands). Inc: Increased; Dec: Decrease; LOS: Length of stay.