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Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness.
PLoS One. 2016; 11(11):e0165923.Plos

Abstract

OBJECTIVE

Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness.

DESIGN

Retrospective cohort study.

SETTING

All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011.

PATIENTS

Stress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression.

MAIN RESULTS

Stress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), p<0.001) and was sustained regardless of age or severity of illness.

CONCLUSIONS

Stress induced hyperglycemia identifies patients at subsequent risk of incident diabetes.

Authors+Show Affiliations

Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia. Discipline of Acute Care Medicine, University of Adelaide, Level 5 Eleanor Harrald Building, Adelaide, South Australia, Australia.Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia. Discipline of Acute Care Medicine, University of Adelaide, Level 5 Eleanor Harrald Building, Adelaide, South Australia, Australia.Discipline of Medicine, University of Adelaide, Level 6 Eleanor Harrald Building, Adelaide, South Australia, Australia. Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia. Discipline of Acute Care Medicine, University of Adelaide, Level 5 Eleanor Harrald Building, Adelaide, South Australia, Australia.Department of Critical Care Medicine, Flinders University, Bedford Park, South Australia, Australia. Department of Intensive Care Medicine, Flinders Medical Centre, Bedford Park, South Australia, Australia.Department of Intensive Care Medicine, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia.Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia.Discipline of Medicine, University of Adelaide, Level 6 Eleanor Harrald Building, Adelaide, South Australia, Australia. Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia. Discipline of Acute Care Medicine, University of Adelaide, Level 5 Eleanor Harrald Building, Adelaide, South Australia, Australia.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

27824898

Citation

Plummer, Mark P., et al. "Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness." PloS One, vol. 11, no. 11, 2016, pp. e0165923.
Plummer MP, Finnis ME, Phillips LK, et al. Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. PLoS ONE. 2016;11(11):e0165923.
Plummer, M. P., Finnis, M. E., Phillips, L. K., Kar, P., Bihari, S., Biradar, V., Moodie, S., Horowitz, M., Shaw, J. E., & Deane, A. M. (2016). Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. PloS One, 11(11), e0165923. https://doi.org/10.1371/journal.pone.0165923
Plummer MP, et al. Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. PLoS ONE. 2016;11(11):e0165923. PubMed PMID: 27824898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness. AU - Plummer,Mark P, AU - Finnis,Mark E, AU - Phillips,Liza K, AU - Kar,Palash, AU - Bihari,Shailesh, AU - Biradar,Vishwanath, AU - Moodie,Stewart, AU - Horowitz,Michael, AU - Shaw,Jonathan E, AU - Deane,Adam M, Y1 - 2016/11/08/ PY - 2016/08/09/received PY - 2016/10/19/accepted PY - 2016/11/9/entrez PY - 2016/11/9/pubmed PY - 2017/7/7/medline SP - e0165923 EP - e0165923 JF - PloS one JO - PLoS ONE VL - 11 IS - 11 N2 - OBJECTIVE: Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness. DESIGN: Retrospective cohort study. SETTING: All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011. PATIENTS: Stress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression. MAIN RESULTS: Stress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), p<0.001) and was sustained regardless of age or severity of illness. CONCLUSIONS: Stress induced hyperglycemia identifies patients at subsequent risk of incident diabetes. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/27824898/Stress_Induced_Hyperglycemia_and_the_Subsequent_Risk_of_Type_2_Diabetes_in_Survivors_of_Critical_Illness_ L2 - http://dx.plos.org/10.1371/journal.pone.0165923 DB - PRIME DP - Unbound Medicine ER -