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Table 2 Glycemic control, ketonemia, ketonuria and acid–base status of diabetic patients with and without permissive hyperglycemia

From: Prevalence of ketosis, ketonuria, and ketoacidosis during liberal glycemic control in critically ill patients with diabetes: an observational study

Variable

All patients

Peak BGL

Peak BGL

P value

≥10 mmol/l

<10 mmol/l

Number of patients, n (%)

60 (100)

46 (77)

14 (23)

 

No. of blood glucose measurements, n (%)

280

229

51

 

No. of blood glucose measurements per patient

4 (3, 7)

4 (3, 7)

3 (2, 5)

0.19

Peak glucose level, mmol/l

12.0 (10.0, 15.0)

14 (12, 17)

8.2 (7.4, 9.5)

<0.001

Mean glucose level, mmol/l

10.0 (8.3, 13.0)

12 (9.5, 13)

7.1 (6.6, 8.3)

<0.001

Min glucose level, mmol/l

8.0 (6.2, 9.4)

8.8 (7, 9.9)

6.2 (5.7, 7.5)

0.007

No. of blood ketone measurements, n (%)

277

228

49

 

No. of blood ketone measurements per patient

4 (3, 7)

4 (3, 7)

3 (2, 4)

0.11

Time between ICU admission until first measurement, hours

8.3 (1.6, 12)

8.9 (1.7, 13)

3.2 (1.5, 11)

0.02

Patients receiving insulin, n (%)

27 (45)

27 (59)

0

 

Intravenous insulin rate, units/h

2 (1, 2)

2 (1, 2)

0

 

Patients receiving nutrition, n (%)

29 (48)

27 (59)

2 (14)

 

 Enteral nutrition, n (%)

28 (47)

26 (57)

2 (14)

 

 Total parenteral nutrition, n (%)

2 (3.3)

2 (4.3)

0

 

Patients receiving catecholamine infusion, n (%)

30 (50)

27 (46)

3 (21)

0.03

 Noradrenaline, n (%)

29 (48)

26 (57)

3 (21)

0.03

 Maximum noradrenaline rate, μg/min

5.0 (2.0, 16)

7.5 (2.0, 16)

2.0 (1.0, 4.0)

0.11

 Adrenaline, n (%)

7 (12)

7 (15)

0

 

 Maximum adrenaline rate, μg/min

3.0 (2.0, 4.0)

3.0 (2.0, 4.0)

NA

 

Ketosis episodes >0.6 mmol/l, n (%)

79 (28.6)

63 (28)

16 (33)

0.43

Peak blood ketones, mmol/l

0.8 (0.3, 1.9)

0.85 (0.2, 1.9)

0.65 (0.3, 1.0)

0.32

Worst ketosis, n (%)

   

0.52

 No ketosis (<0.6 mmol/l)

22 (36.7)

16 (35)

6 (42)

 

 Mild (0.6–1.5 mmol/l)

20 (33.3)

15 (33)

5 (36)

 

 Moderate (1.6–3.0 mmol/l)

11 (18.3)

8 (17)

3 (21)

 

 Marked (>3.0 mmol/l)

7 (11.7)

7 (15)

0

 

Number of urine ketone measurements

261

215

46

 

Worst ketonuria, n (%)

   

0.51

 No ketonuria

40 (66.7)

31 (67)

9 (64)

 

 Mild (1+)

13 (21.7)

10 (22)

3 (21)

 

 Moderate (2+)

6 (10)

5 (11)

1 (7)

 

 Marked (3+)

1 (1.7)

0

1 (7)

 

Patients with alkalosisa, n (%)

25 (42)

20 (43)

5 (36)

0.76

Blood gas analysis, worst value during study period

 pH

7.4 (7.3, 7.4)

7.3 (7.3, 7.4)

7.4 (7.3, 7.4)

0.32

 Lactate, mmol/l

2.2 (1.6, 3.1)

2.3 (1.7, 3.4)

2 (1.4, 2.3)

0.15

 Bicarbonate, mmol/l

22 (20, 24)

22 (19, 24)

25 (23, 26)

0.002

 Chloride, mmol/l

108 (104, 111)

108 (104, 111)

105 (102, 108)

0.10

 Sodium, mmol/l

136 (132, 138)

136 (132, 138)

136 (132, 136)

0.73

 Albumin, g/l

26 (22, 30)

26 (21, 29)

29 (23, 30)

0.75

 Base excess (BE), mmol/l

−2.8 (−5, 0)

−3 (−5, −1)

0.35 (−4, 1)

0.006

ADA ketoacidosis, n (%)

2/60 (3.3)

1/46 (2.2)

1/14 (7.1)

1.00

JBDS ketoacidosis, n (%)

0/60 (0)

   
  1. Values are median (IQR) or n (%)
  2. BGL blood glucose level, ICU intensive care unit, ADA American Diabetes Association, JBDS Joint British Diabetes Society
  3. apH >7.45