Relative Hypoglycemia is Associated with Delirium in Critically Ill Patients with Diabetes: A Cohort Study

2022

Diabetes, Metabolic Syndrome and Obesity, Vol Volume 15, Pp 3339-3346 (2022)

Hui Zhao, Hua-Liang Ying, Chao Zhang,* Shaohua Zhang* Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chao Zhang; Shaohua Zhang, Intensive Care Unit (ICU), Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 1 Tong-yang Road, Taizhou, People’s Republic of China, Tel +8613757602063 ; +8615268325868, Email zhangc@enzemed.com; zhangsh5914@enzemed.comPurpose: Critically ill patients with premorbid diabetes can suffer from relative hypoglycemia (RHG), falling below the normal blood glucose (BG) target. However, these events have not been well defined or studied. In the present study, we aimed to explore the incidence and clinical significance of RHG events in critically ill patients with diabetes.Patients and methods: Patients with a history of diabetes who stayed in the intensive care unit (ICU) for more than three days with at least 12 BG recordings were retrospectively included in the study. A BG level > 30% below the estimated average according to patient hemoglobin A1c measured at admission was defined as a single RHG event. Outcomes were compared between patients with and those without RHG events.Results: In total, 113 patients were included in the final analysis. RHG was detected in 73 patients (64.6%). Those who experienced RHG events had a significantly higher incidence of ICU delirium. They also had a higher risk of 28-day mortality, but this was not statistically significant. However, patients with a higher frequency of RHG events did have a significantly higher risk of overall mortality (57.1% for more than four events vs 15.4% for three to four events, P=0.006 and 15.1% for one to two events, P=0.003).Conclusion: In conclusion, RHG is a common finding in critically ill patients with diabetes and is associated with mortality and the occurrence of delirium.Keywords: relative hypoglycemia, delirium, diabetes, intensive care unit patients

article

English

Dove Medical Press, 2022.

relative hypoglycemia, delirium, diabetes, intensive care unit patients, Specialties of internal medicine, RC581-951