Blood Glucose in Acute Coronary Syndromes. How Low Should You Go?

Martins, Hélia; Monteiro, Sílvia; Gonçalves, Francisco; Monteiro, Pedro; Pêgo, M.

doi:10.1016/j.rec.2014.01.030

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…29–31 If a worsening role of admission hyperglycemia may not be fully endorsed in diabetes, this has always been identified as a predictor of poor prognosis in patients with unknown diabetes. 32–34 While the relationship between blood glucose levels and in-hospital mortality in patients with STEMI is linear in patients without diabetes, 35,36 no association was reported with fasting glucose levels at admission in patients with diabetes and CHD, including STEMI and UA. 37,38 Some evidence suggests that persistent hyperglycemia is a better indicator of prognosis than admission hyperglycemia.…”

Section: Resultsmentioning

confidence: 99%

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Avogaro

Bonora

Consoli

et al. 2019

Diabetes and Vascular Disease Research

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Diabetes is a common comorbidity in patients hospitalized for an acute coronary syndrome event, and prevalence is increasing. Among patients hospitalized with acute myocardial infarction, diabetes can be an independent predictor of mortality and new cardiovascular events; both short- and long-term outcomes are worse for patients with diabetes relative to those without, and undiagnosed diabetes is associated with greater mortality. The impact of glycemic control on cardiovascular outcomes and the best approach to treat hyperglycemia upon hospital admission for acute coronary syndrome in patients with or without known diabetes remain open questions. This review assesses available evidence for hyperglycemia management at the time of admission for acute coronary syndrome and, thereafter, finds that (1) admission plasma glucose plays a role in predicting adverse events, especially in patients with unknown diabetes; (2) glycated haemoglobin is a likely predictor of events in patients with unknown diabetes; and (3) hypoglycemia at the time of acute myocardial infarction hospital admission is an important predictor for mortality in patients with and without diabetes. Whether glucose-targeted insulin and glucose infusion have advantages over glucose–insulin–potassium infusion remains controversial. Evidence for the effect of novel glucose-lowering agents used at the time of an acute cardiovascular event is limited and requires more dedicated studies.

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Section: Resultsmentioning

confidence: 99%

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Avogaro

Bonora

Consoli

et al. 2019

Diabetes and Vascular Disease Research

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“…In addition to the development of stress hyperglycemia, diabetic patients represent a significant volume of admissions to intensive care units. The prevalence of hyperglycemia is close to 50% in septic patients 2 and those with acute coronary syndrome, 3 and around 40% in acute stroke 4 …”

Section: Introductionmentioning

confidence: 99%

Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients

Rodriguez-Delgado

Moral

Cobos‐Vargas

et al. 2021

Nursing in Critical Care

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Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters. Aims and objectives: To analyse the agreement between arterial, central venous, and capillary blood samples of glucose values measured by glucose meter in critically ill patients and study potential confounding factors. Design: Prospective cross-sectional study in a general intensive care unit (ICU). Patients needing insulin treatment (subcutaneous or intravenous) and blood glucose control were included. Methods: Standardized collection of blood samples and measurement of glucose values with a glucometer. Agreement was studied by the Bland-Altman method and stratified analysis of disagreement-survival plots was used to study the influence of haematocrit, pH range, SOFA score, capillary refilling time, intravenous insulin infusion, and lactic acid.Results: A total of 297 measurements from 54 patients were included. The mean arterial blood glucose was 150.42 (range 31-345 mg/dL). In the graphical analysis, there is a poor agreement both in capillary and venous central to arterial samples, but in opposite direction (underestimation of capillary and overestimation of central venous). Factors associated with a reduction in the agreement between arterial and capillary samples were elevated lactate, poor capillary refilling, and hemodynamic failure. Patients without hemodynamic compromise have an acceptable agreement with values for absolute differences of 16 mg/dL for a disagreement of 10%. Conclusions:In critically ill patients, the measurement of blood glucose with a glucose meter should be performed with arterial samples whenever possible. Capillary samples do not accurately estimate arterial blood glucose values in patients with

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Promoción de estilos de vida saludable: una alternativa para el manejo de la Diabetes Mellitus tipo II

Muñoz Bowen,

Piñón Gamez,

Garcia Labrada

et al. 2023

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Este trabajo se enfocó en el desconocimiento que existe sobre la promoción y prevención de la salud, específicamente de la Diabetes Mellitus tipo 2 (DM2), que es una de las principales causas de morbimortalidad a nivel mundial. Se proyectó realizar una revisión teórica sobre la DM2 y la promoción de estilos de vida saludable en pacientes que padecen esta enfermedad. La metodología utilizada se basó en el análisis teórico mediante métodos científicos que orientan el razonamiento de lo general a lo específico, considerando perspectivas de otros investigadores y llegando a plantear conclusiones propias de esta investigación. La información recopilada tuvo una alta calidad académica y científica, seleccionando cuidadosamente los artículos actualizados para respaldar las investigaciones que fundamentaron los factores de riesgo de la DM2: la edad, el sexo, la etnia, la susceptibilidad genética, la diabetes gestacional, el bajo peso al nacer, la lactancia materna, la obesidad, la dieta, el consumo de alcohol, el sedentarismo y la hipertensión arterial. Se concluye que la educación en hábitos de vida saludable, la detección temprana y el control de los factores de riesgo son fundamentales en el manejo y tratamiento de la DM2. Palabras claves: diabetes; pacientes, prevención, riesgos, salud

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Blood Glucose in Acute Coronary Syndromes. How Low Should You Go?

Cited by 4 publications

References 21 publications

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Glucose-lowering therapy and cardiovascular outcomes in patients with type 2 diabetes mellitus and acute coronary syndrome

Agreement of blood glucose measured with glucose meter in arterial, central venous, and capillary samples in adult critically ill patients

Promoción de estilos de vida saludable: una alternativa para el manejo de la Diabetes Mellitus tipo II

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