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    ncreased glycemic variability is independently associated with length of stay and mortality in noncritically ill hospitalized patients

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    Author
    Mendez, Carlos E.; Mok, Ki-Tae; Ata, Ashar; Tanenberg, Robert J.; Calles-Escandon, Jorge; Umpierrez, Guillermo E.
    Abstract
    OBJECTIVE: To investigate the association between glycemic variability (GV) and both length of stay (LOS) and 90-day mortality in noncritically ill hospitalized patients. RESEARCH DESIGN AND METHODS: This study retrospectively analyzed 4,262 admissions to the general medicine or surgery services during a 2 year period. Patients with point-of-care glucose monitoring and a minimum of two glucose values per day on average were selected. GV was assessed by SD and coefficient of variation (CV). Data were analyzed with linear and logistic multivariate regression analysis in separate models for SD and CV. Analysis was performed with generalized estimating equations to adjust for correlation between multiple admissions in some individual cases. RESULTS: After exclusions, 935 admissions comprised the sample. Results of adjusted analysis indicate that for every 10 mg/dL increase in SD and 10-percentage point increase in CV, LOS increased by 4.4 and 9.7%, respectively. Relative risk of death in 90 days also increased by 8% for every 10-mg/dL increase in SD. These associations were independent of age, race, service of care (medicine or surgery), previous diagnosis of diabetes, HbA1c, BMI, the use of regular insulin as a sole regimen, mean glucose, and hypoglycemia occurrence during the hospitalization. CONCLUSIONS: Our results indicate that increased GV during hospitalization is independently associated with longer LOS and increased mortality in noncritically ill patients. Prospective studies with continuous glucose monitoring are necessary to investigate this association thoroughly and to generate therapeutic strategies targeted at decreasing GV.
    URI
    http://hdl.handle.net/10342/7754
    Date
    2013-10-29
    Citation:
    APA:
    Mendez, Carlos E., & Mok, Ki-Tae, & Ata, Ashar, & Tanenberg, Robert J., & Calles-Escandon, Jorge, & Umpierrez, Guillermo E.. (October 2013). ncreased glycemic variability is independently associated with length of stay and mortality in noncritically ill hospitalized patients. Diabetes Care, (36:1), p.4091-4097. Retrieved from http://hdl.handle.net/10342/7754

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    MLA:
    Mendez, Carlos E., and Mok, Ki-Tae, and Ata, Ashar, and Tanenberg, Robert J., and Calles-Escandon, Jorge, and Umpierrez, Guillermo E.. "ncreased glycemic variability is independently associated with length of stay and mortality in noncritically ill hospitalized patients". Diabetes Care. 36:1. (4091-4097.), October 2013. March 06, 2021. http://hdl.handle.net/10342/7754.
    Chicago:
    Mendez, Carlos E. and Mok, Ki-Tae and Ata, Ashar and Tanenberg, Robert J. and Calles-Escandon, Jorge and Umpierrez, Guillermo E., "ncreased glycemic variability is independently associated with length of stay and mortality in noncritically ill hospitalized patients," Diabetes Care 36, no. 1 (October 2013), http://hdl.handle.net/10342/7754 (accessed March 06, 2021).
    AMA:
    Mendez, Carlos E., Mok, Ki-Tae, Ata, Ashar, Tanenberg, Robert J., Calles-Escandon, Jorge, Umpierrez, Guillermo E.. ncreased glycemic variability is independently associated with length of stay and mortality in noncritically ill hospitalized patients. Diabetes Care. October 2013; 36(1) 4091-4097. http://hdl.handle.net/10342/7754. Accessed March 06, 2021.
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