Table 2.
Glycemic control, ketonemia, ketonuria and acid–base status of diabetic patients with and without permissive hyperglycemia
| Variable | All patients | Peak BGL | Peak BGL | P value |
|---|---|---|---|---|
| ≥10 mmol/l | <10 mmol/l | |||
| Number of patients, n (%) | 60 (100) | 46 (77) | 14 (23) | |
| No. of blood glucose measurements, n (%) | 280 | 229 | 51 | |
| No. of blood glucose measurements per patient | 4 (3, 7) | 4 (3, 7) | 3 (2, 5) | 0.19 |
| Peak glucose level, mmol/l | 12.0 (10.0, 15.0) | 14 (12, 17) | 8.2 (7.4, 9.5) | <0.001 |
| Mean glucose level, mmol/l | 10.0 (8.3, 13.0) | 12 (9.5, 13) | 7.1 (6.6, 8.3) | <0.001 |
| Min glucose level, mmol/l | 8.0 (6.2, 9.4) | 8.8 (7, 9.9) | 6.2 (5.7, 7.5) | 0.007 |
| No. of blood ketone measurements, n (%) | 277 | 228 | 49 | |
| No. of blood ketone measurements per patient | 4 (3, 7) | 4 (3, 7) | 3 (2, 4) | 0.11 |
| Time between ICU admission until first measurement, hours | 8.3 (1.6, 12) | 8.9 (1.7, 13) | 3.2 (1.5, 11) | 0.02 |
| Patients receiving insulin, n (%) | 27 (45) | 27 (59) | 0 | |
| Intravenous insulin rate, units/h | 2 (1, 2) | 2 (1, 2) | 0 | |
| Patients receiving nutrition, n (%) | 29 (48) | 27 (59) | 2 (14) | |
| Enteral nutrition, n (%) | 28 (47) | 26 (57) | 2 (14) | |
| Total parenteral nutrition, n (%) | 2 (3.3) | 2 (4.3) | 0 | |
| Patients receiving catecholamine infusion, n (%) | 30 (50) | 27 (46) | 3 (21) | 0.03 |
| Noradrenaline, n (%) | 29 (48) | 26 (57) | 3 (21) | 0.03 |
| Maximum noradrenaline rate, μg/min | 5.0 (2.0, 16) | 7.5 (2.0, 16) | 2.0 (1.0, 4.0) | 0.11 |
| Adrenaline, n (%) | 7 (12) | 7 (15) | 0 | |
| Maximum adrenaline rate, μg/min | 3.0 (2.0, 4.0) | 3.0 (2.0, 4.0) | NA | |
| Ketosis episodes >0.6 mmol/l, n (%) | 79 (28.6) | 63 (28) | 16 (33) | 0.43 |
| Peak blood ketones, mmol/l | 0.8 (0.3, 1.9) | 0.85 (0.2, 1.9) | 0.65 (0.3, 1.0) | 0.32 |
| Worst ketosis, n (%) | 0.52 | |||
| No ketosis (<0.6 mmol/l) | 22 (36.7) | 16 (35) | 6 (42) | |
| Mild (0.6–1.5 mmol/l) | 20 (33.3) | 15 (33) | 5 (36) | |
| Moderate (1.6–3.0 mmol/l) | 11 (18.3) | 8 (17) | 3 (21) | |
| Marked (>3.0 mmol/l) | 7 (11.7) | 7 (15) | 0 | |
| Number of urine ketone measurements | 261 | 215 | 46 | |
| Worst ketonuria, n (%) | 0.51 | |||
| No ketonuria | 40 (66.7) | 31 (67) | 9 (64) | |
| Mild (1+) | 13 (21.7) | 10 (22) | 3 (21) | |
| Moderate (2+) | 6 (10) | 5 (11) | 1 (7) | |
| Marked (3+) | 1 (1.7) | 0 | 1 (7) | |
| Patients with alkalosisa, n (%) | 25 (42) | 20 (43) | 5 (36) | 0.76 |
| Blood gas analysis, worst value during study period | ||||
| pH | 7.4 (7.3, 7.4) | 7.3 (7.3, 7.4) | 7.4 (7.3, 7.4) | 0.32 |
| Lactate, mmol/l | 2.2 (1.6, 3.1) | 2.3 (1.7, 3.4) | 2 (1.4, 2.3) | 0.15 |
| Bicarbonate, mmol/l | 22 (20, 24) | 22 (19, 24) | 25 (23, 26) | 0.002 |
| Chloride, mmol/l | 108 (104, 111) | 108 (104, 111) | 105 (102, 108) | 0.10 |
| Sodium, mmol/l | 136 (132, 138) | 136 (132, 138) | 136 (132, 136) | 0.73 |
| Albumin, g/l | 26 (22, 30) | 26 (21, 29) | 29 (23, 30) | 0.75 |
| Base excess (BE), mmol/l | −2.8 (−5, 0) | −3 (−5, −1) | 0.35 (−4, 1) | 0.006 |
| ADA ketoacidosis, n (%) | 2/60 (3.3) | 1/46 (2.2) | 1/14 (7.1) | 1.00 |
| JBDS ketoacidosis, n (%) | 0/60 (0) | |||
Values are median (IQR) or n (%)
BGL blood glucose level, ICU intensive care unit, ADA American Diabetes Association, JBDS Joint British Diabetes Society
apH >7.45