Changes In Blood Sugar May Affect Patient Outcomes
Patients having a deadly blood infection combined with uncontrolled blood sugar levels are less likely to survive a critical illness, according to a new study.
Critical care researchers at The Ohio State University Medical Center studied more than 1,200 critically ill septic patients from intensive care units to determine if dramatic fluctuations in blood glucose were associated with the likelihood that a patient would die.
The researchers found that large swings in blood sugar levels are independently associated with hospital mortality among intensive care patients with sepsis, according to Dr. Naeem Ali, a pulmonologist and critical care specialist at Ohio State’s Medical Center.
The findings were recently published in the journal Critical Care Medicine.
“Recent studies in patients with sepsis using insulin to lower blood sugar had to be stopped because of safety concerns. Additionally, there did not appear to be an overall benefit to aggressively reducing blood sugar to normal levels for septic patients,” says Ali, who is also principal investigator of the study.
Patients under medical stress often have hyperglycemia, an abnormally high concentration of glucose in the bloodstream. This condition also may weaken a patient’s ability to heal wounds or fight off infection. Other studies have shown that aggressive management of hyperglycemia in critically ill patients improves survival, reduces infections and decreases complications.
Sepsis, a systemic response to infection, can lead to organ failure, shock and death. Sepsis affects approximately 750,000 Americans yearly and kills more people than strokes, breast cancer and lung cancer combined.
“Observation of septic patients showed a five-fold increase in the odds of hospital death each time there was variability in glucose levels,” Ali said. In addition, researchers found a higher than average level of variability in glucose measures was more tightly linked to mortality than any other measure of glucose that was analyzed.
“We found that independent of blood sugar, glucose variability was independently associated with mortality,” adds Ali.
According to Ali, future research should focus glucose management in patients with sepsis, including glucose variability as a target for therapeutic intervention.