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Table 1 Summary of included studies evaluating subsequent risk of diabetes in critically ill patients with stress hyperglycaemia

From: Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: a systematic review and meta-analysis

First author, year [reference]

Study design, location and recruitment period

Follow-up duration

Participants

Recruitment: total number (normal/SH); males %; age in years, median (IQR)

Follow-up: number completing; normal (%), SH (%)

SH definition

Nutrition

Number of new cases of diabetes; normal (%), SH (%)

Methods used to: (1) diagnose incident diabetes and (2) exclude baseline diabetes

Gornik, 2010 [21]

Single-centre, PC, Croatia, July 1998–June 2004

5 years

Medical patients with no history of steroid use, pancreatitis, disturbed glucose metabolism or other endocrine disorder who were admitted to ICU

1029 (669/360); 55 % males; age, normal 58 years (19–86), SH 59 years (22–87)

591; normal 398 (67 %), SH 193 (33 %)

Venous BG in ICU >7.7 mmol/L, measured twice per day with point-of-care blood gas analyser

EN and PN

47; normal 14 (4 %), SH 33 (17 %)

(1) Annual OGTT for 5 yearsa (2) History; OGTT 4–6 weeks after discharge

Gornik, 2010 [22]

Single-centre, PC, Croatia, January 2000–December 2002

5 years

Patients admitted to ICU with sepsis, acute coronary syndrome and acute heart failure with no history of disturbed glucose metabolism or steroid use

258 (168/90); 54 % males; age, normal 57 years (48–65), SH 60 years (49–65)

166; normal 115 (69 %), SH 51 (31 %)

Random venous BG in ICU >7.7 mmol/L on at least two occasions

Not stated

12; normal 4 (3 %), SH 8 (16 %)

(1) OGTT: follow-up of at least 5 years but frequency not specifieda (2) History; absence of hyperglycaemia before discharge

McAllister, 2014 [23]

Multi-centre, RC, Scotland, December 2004–November 2008

3 years

Patients aged ≥30 years with an emergency admission to hospital between 2004 and 2008b

1828b; sex and age not specified for ICU subgroup

1828; normal 1620 (89 %), SH 208 (11 %)b

Admission BG (first BG taken within 2 days of admission) ≥11.1 mmol/L

Not stated

48; normal 37 (2 %), SH 11 (5 %)b

(1) Record of new diagnosis in national registerc between 31 days and 3 years after discharge (2) Record in national registerc prior to admission or within 30 days of discharge; admission BG >20 mmol/L

Van Ackerbroeck, 2015 [24]

Single-centre, PC, Belgium, September 2011–March 2013

8 months

Patients aged 18–85 years admitted to a medical-surgical ICU for ≥48 h; patients with pancreatitis, known disturbed glucose metabolism and those using glucose-lowering drugs excluded

385d; 66 % males; age, normal 56 years (18–82), SH 62 years (20–88)

338; normal 92 (27 %), SH 246 (73 %)

Arterial BG >140 mg/dl (>7.8 mmol/L) measured using on-site blood gas analyser

EN and PN

24; normal 4 (4 %), SH 20 (8 %)

(1) OGTT with or without HbA1c 8 months after ICU admissiona (2) History; medication review; with or without HbA1ce

  1. Abbreviations: PC Prospective cohort, RC Retrospective cohort, ICU Intensive care unit, SH Stress hyperglycaemia, BG Blood glucose, EN Enteral nutrition, PN Parenteral nutrition, OGTT Oral glucose tolerance test, HbA1c Glycated haemoglobin, IQR interquartile range
  2. aDiabetes defined according to American Diabetes Association criteria: fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L during a 75-g OGTT performed as described by the World Health Organisation or HbA1c ≥6.5 % (48 mmol/mol) [19]
  3. bOnly the subgroup of 1828 patients admitted to ICU is included in the analysis. The total number of patients included in the study is 86,634
  4. cScottish Care Information-Diabetes Collaboration is a national register including >99 % of people with diabetes in Scotland
  5. dNumber of patients with normoglycaemia and stress hyperglycaemia in original cohort not stated
  6. eAdmission HbA1c measured in only 45 % of study population. HbA1c ≥6.5 % (48 mmol/mol) considered diagnostic of diabetes
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Critical Care

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