Volume 14 Supplement 1

30th International Symposium on Intensive Care and Emergency Medicine

Open Access

Blood glucose amplitude variation: effects of intensive insulin therapy and relative association with mortality

  • E Bekaert1,
  • P Wouters1,
  • A Wilmer1,
  • G Van den Berghe1 and
  • G Meyfroidt1
Critical Care201014(Suppl 1):P575

https://doi.org/10.1186/cc8807

Published: 1 March 2010

Introduction

There is growing evidence that not only blood glucose (BG) level but also BG amplitude variation (BGAV) is associated with mortality in critically ill patients [1].

Methods

Retrospective analysis of the data of the Leuven intensive insulin therapy (IIT) trial in 1,200 MICU patients, randomized to receive either IIT or conventional insulin therapy [2]. The hyperglycemic index (HGI) and hypoglycemic index (HoGI) were used as measures of BG level, the standard deviation of all BG readings per patient (SD BG) as a measure of BGAV. The univariable effect of IIT on these indices was analyzed, the independent association with hospital mortality was assessed by multivariable logistic regression (MVR), corrected for baseline risks.

Results

IIT reduced the median HGI from 3.2 to 0.8 mmol/l (P < 0.0001), increased the median HoGI from 0.005 to 0.048 mmol/l (P < 0.0001), and did not affect median SD BG (conventional: 2.12; IIT: 1.99 mmol/l (P = 0.161)). The results of the MVR are summarized in Table 1. HGI, HoGI and SD BG were independently associated with mortality.

Table 1

Risk

Pvalue

Malign

<0.001

Female

0.309

BMI >25

0.044

Age

0.001

Adm BG

0.002

HGI

<0.001

HoGI

0.003

SD BG

0.024

Conclusions

BGAV was associated with mortality in MICU patients, independent of baseline risks and BG level. IIT reduced HGI, increased HoGI, and did not affect BGAV. Reducing BGAV, in addition to IIT, may theoretically increase its potential for clinical benefit.

Authors’ Affiliations

(1)
UZ Leuven

References

  1. Krinsley , et al: Crit Care Med. 2008, 36: 3008-3013. 10.1097/CCM.0b013e31818b38d2.View ArticleGoogle Scholar
  2. Berghe Van den , et al: N Engl J Med. 2006, 354: 449-461. 10.1056/NEJMoa052521.View ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2010

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