Glycemic Gap Versus Admission Plasma Glucose Level As Predictors of ICU Out Comes in Type 2 Diabetic Patients With Acute Heart Failure
Study Details
Study Description
Brief Summary
assess the relation between glycemic gab and adverse clinical outcomes in diabetic patients who hospitalized with heart failure
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Detailed Description
Hyperglycemia is a common problem in patients wi9non-diabetic patients but not in patients with diabetes . The relationship between admission hyperglycemia and mortality in diabetic patients with AHF or critical illness remains controversial . Those discrepancies could be partly attributed to long-term glycemic control in diabetic patients.
Critical illness can induce stress-induced hyperglycemia (SIH), which results from the excess release of counter-regulatory hormones and anti-inflammatory cytokines, leading to augmented gluconeogenesis and insulin resistance.
In diabetic patients with acute illness, the phenomenon of admission hyperglycemia could be connected with acute physiological stress, poorer glycemic controls, or a combination of both . It is necessary to think about background glycemic control when exploring the relationships between admissions Hyperglycemia and clinical outcomes. Recent studies have shown that hemoglobin A1c (HbA1c)-based adjusted glycemic variables, including glycemic gap and stress hyperglycemia ratio, were linked to severity of disease and unfavorable prognosis in diabetic patients with some infectious diseases, cardiovascular diseases and clinical illness
Study Design
Outcome Measures
Primary Outcome Measures
- Glycemic gap versus admission plasma glucose level As predictors of ICU out comes in type 2 diabetic patients with acute heart failure [through study completion an avarage 1 year]
Glycemic gap versus admission plasma glucose level As predictors of ICU out comes in type 2 diabetic patients with acute heart failure
Eligibility Criteria
Criteria
Inclusion Criteria:
- All diabetic patients admitted to ICU of internal medicine department from October 2020 to November 2021 by heart failure
Exclusion Criteria:
- Age ≤18 years.
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Hypoglycemia (plasma glucose <70 mg/dL) at initial presentation.
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An admission diagnosis of diabetic ketoacidosis or hyperosmolar hyperglycemic state.
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Patients with hemoglobin variants (e.g., sickle cell anemia, thalassemia) or with hematologic conditions (e.g., hemolytic anemia) that could interfere with the accuracy of the HbA1c assay.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Assiut University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- de Miguel-Yanes JM, Gonzalo-Hernando C, Muñoz-Rivas N, Méndez-Bailón M, Cava-Valenciano F, Torres-Macho J. First plasma glucose value after urgent admission and in-hospital mortality in acutely decompensated heart failure. Heart Lung. 2015 Mar-Apr;44(2):137-40. doi: 10.1016/j.hrtlng.2014.11.006. Epub 2014 Dec 18.
- Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet. 2009 May 23;373(9677):1798-807. doi: 10.1016/S0140-6736(09)60553-5. Review.
- Lazzeri C, Valente S, Chiostri M, D'Alfonso MG, Spini V, Angelotti P, Gensini GF. Admission Glycaemia and Acute Insulin Resistance in Heart Failure Complicating Acute Coronary Syndrome. Heart Lung Circ. 2015 Nov;24(11):1074-80. doi: 10.1016/j.hlc.2015.04.171. Epub 2015 May 16.
- Yang CJ, Liao WI, Wang JC, Tsai CL, Lee JT, Peng GS, Lee CH, Hsu CW, Tsai SH. Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke. Am J Emerg Med. 2017 Sep;35(9):1240-1246. doi: 10.1016/j.ajem.2017.03.049. Epub 2017 Mar 22.
- Glycemic gap