The diagnosis of diabetes mellitus type 2 (DM2) is based either on increased plasma glucose or Glycated hemoglobin levels. Since these measures are the only means for diagnosis of DM2, they must be well adapted to each population according to their metabolic characteristics, given that these may vary in each population. The World Health Organization (WHO) determined the cut-points of plasma glucose levels for the diagnosis of DM2 by associating hyperglycemia with the risk of a specific microvascular complication-retinopathy. Cardiovascular diseases are however the principal causes of mortality in patients with DM2 and we reported that in the Colombo-Ecuadorian population impaired fasting glucose and impaired glucose tolerance are both risk markers for myocardial infarction. We propose that the current cut-points accepted by the WHO need to be revaluated in populations such as Latin America and that there should be lower cut points for glycaemia in this population, to reduce the prevalence of cardiovascular complications associated with DM2.

PURPOSE: Recent research has revealed that early lactate clearance is associated with a reduction in inflammatory markers and improved clinical outcomes in septic shock. Acute respiratory distress syndrome (ARDS) is a well-established complication of septic shock, yet little is known about the relationship between ARDS and lactate clearance. The aim here was to evaluate whether improved lactate clearance is associated with improved outcomes in patients with septic shock complicated by ARDS.

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