Effect of Glycemic Control on Sepsis in Critically Ill Diabetic Patients: a Prospective Cohort Study

Abstract

espite advances in the management of patients with diabetes mellitus (DM), this population still has a poorer prognosis after ischemic events compared with nondiabetic patients. Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). The target for glucose management in this population and its relationship with the patients’ outcome is not clear, and results from literature are contrasting. Some evidences state that hyperglycemia, with a threshold value of 180 mg/dL, relates to an increased risk of death and morbidity due to infection in ICU patients. Several recent clinical trials in critically ill patients have reported no reduction in mortality from intensive treatment targeting near- euglycemia versus conventional management targeting BG 180 mg/dl (10.0 mmol/l). So, glucose control in the intensive care unit adds yet another facet to the routine care of a highly complex patient profile. Although observational studies and certain interventional trials have suggested that intensive glucose control can reduce mortality in this setting, recent studies