An exploration of glycemic gap as a biomarker to predict intensity and consequence of pulmonary embolism in diabetic patients

Abstract

Pulmonary embolism is a substantial disease with high rate of both morbidity and mortality, which becomes more prevalent in documented diabetic patients.The aim of the present study was to evaluate the contribution of glycemic gap as a biomarker towards defining the intensity and consequence of pulmonary embolism in diabetic patients.Diabetic patients who were admitted to Khaja Banda Nawaz Institute of Medical Sciences with a confirmed diagnosis of pulmonary embolism, during the period between January 2019 and September 2020 were enlisted for the present study. Patients selected for the study were in the age group of ≥18 years and they were from either gender.The present study selected 162 diabetic patients (among them 80 were females and 82 were males), with mean age of 48.6±6.6years. Out of 162 patients, 136 (84%) were survivors and26 (16.0%) were non-survivors. Among survivors, 13 (8%) patients showed clinical deterioration with time and 21 (12.8%) patients needed ICU admission. Non- survivors had advanced age group (53.3±3.4 vs. 49.2±3.2, p=0.002), higher PESI (102±21.7 vs. 74.6±14.3, p<0.001) and prolonged hospital stay (4.9±0.29 days vs. 4.1±0.23 days, p<0.001). There was a highly significant difference regarding the glycemic gap between non- survivors and survivors (37.3±9.3 vs. 83.1±11.6, p<0.001), patients with and without clinical deterioration (104.02±12.3 vs. 47.2±12.3, p<0.001), and patients who were and were not in-need of ICU admission (43.1±14.8 vs. 106.2±23.7, p<0.001). Resultsof the present study proves that uplifted level of glycemic gap between serum glucose levels upon admission and the HbA1c-derived average glucose was showing strong correlation to the increase in rigourness of disease along with rate of mortality in diabetic patients with pulmonary embolism. Therefore, we proposed to use glycemic gap as a biomarker in predicting the severity and prognosis of pulmonary embolism.