Conner Therese M, Flesner-Gurley Kelly R, Barner Jamie C
Brain and Spine Center, Seton Healthcare Network, 601 E. 15th Street, Austin, TX 78701-1096, USA.
Ann Pharmacother. 2005 Mar;39(3):492-501. doi: 10.1345/aph.1E308. Epub 2005 Feb 8.
To review studies on the role of hyperglycemia in acutely ill adults, regardless of diabetes diagnosis, and the impact of glucose control on health outcomes.
Searches on Ovid MEDLINE, Ovid Evidence-Based Medicine (EBM), and PubMed MEDLINE, limited to articles written in English, trials conducted on adult subjects, and material published between 1994 and April 2004. Search words included the major MeSH term hyperglycemia and title words glucose, hyperglycemia/hyperglycemic, or insulin therapy, with text words admission, hospitalized, in-hospital, or inpatient.
All articles identified from the data sources were evaluated, and all information deemed relevant was included in this review.
Hyperglycemia, even in patients without diabetes, has been shown to be detrimental among inpatients in medical and surgical units, as well as in critical care. A review of 25 outcomes studies indicated that the majority of research on this topic used retrospective or prospective cohort designs; only 2 were conducted as randomized controlled studies. In general, the findings demonstrated negative impact on outcomes among various patient populations with hyperglycemia including increased lengths of stay, health complications, utilization of resources, and risk of mortality.
Studies report that hyperglycemia is a common but detrimental condition and that better control in the hospital setting decreases short- and long-term risk of mortality, illness complications, hospital lengths of stay, and healthcare costs. Increased efforts to treat hyperglycemia and screen for diabetes are needed in the hospital setting. Future studies on cost-effective approaches to glucose control are recommended.
回顾关于高血糖在成年急症患者中的作用的研究，无论其是否被诊断为糖尿病，以及血糖控制对健康结局的影响。
检索Ovid MEDLINE、Ovid循证医学（EBM）和PubMed MEDLINE，仅限于用英文撰写的文章、针对成年受试者进行的试验以及1994年至2004年4月期间发表的资料。检索词包括主要医学主题词高血糖以及标题词葡萄糖、高血糖/高血糖症或胰岛素治疗，文本词包括入院、住院、住院期间或住院患者。
对从数据来源中识别出的所有文章进行评估，所有被认为相关的信息均纳入本综述。
高血糖，即使在无糖尿病患者中，在医疗和外科病房的住院患者以及重症监护患者中也已显示出有害作用。对25项结局研究的综述表明，关于该主题的大多数研究采用回顾性或前瞻性队列设计；仅2项为随机对照研究。总体而言，研究结果表明高血糖对不同患者群体的结局有负面影响，包括住院时间延长、健康并发症、资源利用和死亡风险增加。
研究报告称高血糖是一种常见但有害的状况，在医院环境中更好地控制血糖可降低短期和长期的死亡风险、疾病并发症、住院时间和医疗费用。在医院环境中需要加大治疗高血糖和筛查糖尿病的力度。建议未来开展关于血糖控制成本效益方法的研究。
