Effect of in-hospital glycemic variability on mortality in patients with diabetes

Jordán-Domingo, M.; Gimeno-Orna, José Antonio; Lahoza-Pérez, M.C.; Ilundain-González, Ana Isabel; Agudo-Tabuenca, Ana; Sáenz-Abad, D.

doi:10.1016/j.rceng.2019.12.014

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Frequent and extensive within-day GV independently increases the risk of T2D inpatients experiencing hypoglycemia ( Kauffmann et al, 2011 ; Monnier et al, 2011 ; Bajaj et al, 2017 ) and cardiovascular complications ( Monnier et al, 2006 ; Saisho, 2014 ; Nusca et al, 2018 ; Scott et al, 2020 ). This association has further been linked to prolonged hospital stays and increased long-term mortality rates ( Mendez et al, 2013 ; Akirov et al, 2017 ; Timmons et al, 2017 ; Akirov et al, 2019 ; Jordán-Domingo et al, 2021 ). The growing recognition of stable within-day GV’s importance in T2D management highlights its potential as a novel target for glycemic control therapy.…”

Section: Introductionmentioning

confidence: 99%

Observational study on stability of within-day glycemic variability of type 2 diabetes inpatients treated with decoctions of traditional Chinese medicine

Xing,

Li,

Pang

et al. 2024

Front. Pharmacol.

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BackgroundWithin-day glycemic variability (GV), characterized by frequent and significant fluctuations in blood glucose levels, is a growing concern in hospitalized patients with type 2 diabetes mellitus (T2DM). It is associated with an increased risk of hypoglycemia and potentially higher long-term mortality rates. Robust clinical evidence is needed to determine whether traditional Chinese medicine (TCM) decoctions can be a beneficial addition to the management of within-day GV in this patient population.MethodsThis retrospective cohort study utilized data from adult inpatients diagnosed with T2DM admitted to the Traditional Chinese Medicine Hospital of Kaifeng. The primary outcome investigated was the association between the use of TCM decoctions and improved stability of within-day GV. Blood glucose variability was assessed using the standard deviation of blood glucose values (SDBG). For each patient, the total number of hospitalization days with SDBG below 2 mmol/L was calculated to represent within-day GV stability. Hospitalization duration served as the secondary outcome, compared between patients receiving TCM decoctions and those who did not. The primary analysis employed a multivariable logistic regression model, with propensity score matching to account for potential confounding variables.ResultsA total of 1,360 patients were included in the final analysis. The use of TCM decoctions was significantly associated with enhanced stability of within-day GV (OR = 1.77, 95% CI: 1.34–2.33, P < 0.01). This association was most prominent in patients with a diagnosis of deficiency syndrome (predominantly qi-yin deficiency, accounting for 74.8% of cases) and a disease duration of less than 5 years (OR = 2.28, 95% CI: 1.21–4.29, P = 0.03). However, TCM decoctions did not exert a statistically significant effect on hospitalization duration among patients with T2DM (OR = 0.96, 95% CI: 0.91–1.01, P = 0.22).ConclusionThis study suggests that TCM decoctions may be effective in improving within-day GV stability in hospitalized patients with T2DM. This effect appears to be most pronounced in patients diagnosed with deficiency syndrome, particularly those with qi-yin deficiency and a shorter disease course. Further investigation is warranted to confirm these findings and elucidate the underlying mechanisms.

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Section: Introductionmentioning

confidence: 99%

Observational study on stability of within-day glycemic variability of type 2 diabetes inpatients treated with decoctions of traditional Chinese medicine

Xing,

Li,

Pang

et al. 2024

Front. Pharmacol.

View full text Add to dashboard Cite

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Derived Time in Range and Other Metrics of Poor Glycemic Control Associated With Adverse Hospital Outcomes in Patients With Diabetes Mellitus Admitted to Non‐ICU Wards at a Tertiary‐Level Hospital in Colombia: A Cross‐Sectional Study

Mora Garzón,

González Montoya,

Hernández Herrera

2024

Journal of Diabetes Research

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Aim: This study is aimed at assessing the prevalence of poor glycemic control using different metrics and its association with in‐hospital adverse outcomes.Methods: This cross‐sectional study was conducted in diabetic patients admitted to a third‐level hospital in Colombia between January and July 2022. Poor glycemic control was determined using capillary glucose metrics, including mean glucose values outside the target range, derived time in range (dTIR) (100–180 mg/dL) < 70%, coefficient of variation (CV > 36%), and hypoglycemia (<70 mg/dL). Multiple regression models were adjusted for hospital outcomes based on glycemic control, as well as other sociodemographic and clinical covariates.Results: A total of 330 Hispanic patients were included. A total of 27.6% had mean glucose measurements outside the target range, 33% had a high CV, 64.8% had low dTIR, and 28.8% experienced hypoglycemia. The in‐hospital mortality rate was 8.8%. An admission HbA1c level greater than 7% was linked to an increased mortality risk (p = 0.016), as well as a higher average of glucometer readings (186 mg/dL vs. 143 mg/dL; p < 0.001). A lower average of dTIR (41.0% vs. 60.0%; p < 0.001) was also associated with a higher mortality risk. Glycemic variability was correlated with an increased risk of mortality, hypoglycemia, delirium, and length of hospital stay (LOS).Conclusion: A significant number of hospitalized diabetic patients exhibit poor glycemic control, which has been found to be associated with adverse outcomes, including increased mortality. Metrics like dTIR and glycemic variability should be considered as targets for glycemic control, highlighting the need for enhanced management strategies.

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Effect of in-hospital glycemic variability on mortality in patients with diabetes

Cited by 2 publications

References 22 publications

Observational study on stability of within-day glycemic variability of type 2 diabetes inpatients treated with decoctions of traditional Chinese medicine

Observational study on stability of within-day glycemic variability of type 2 diabetes inpatients treated with decoctions of traditional Chinese medicine

Derived Time in Range and Other Metrics of Poor Glycemic Control Associated With Adverse Hospital Outcomes in Patients With Diabetes Mellitus Admitted to Non‐ICU Wards at a Tertiary‐Level Hospital in Colombia: A Cross‐Sectional Study

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