Department of Intensive Care Medicine, University Hospital Centre Rebro, Zagreb 10000, Croatia.
J Crit Care. 2010 Jun;25(2):263-9. doi: 10.1016/j.jcrc.2009.10.002. Epub 2009 Nov 14.
Hyperglycemia is frequent in sepsis, even in patients without diabetes or impaired glucose metabolism. It is a consequence of inflammatory response and stress, so its occurrence is related to severity of illness. However, not all severely ill develop hyperglycemia and some do even in mild disease. We hypothesized the existence of latent disturbance of glucose metabolism that contributes to development of hyperglycemia and that those patients might have increased risk for diabetes.
Patients admitted with sepsis and no history of impaired glucose metabolism were included and divided in the hyperglycemia group (glucose >or=7.8 mmol/L) and normoglycemia group. Severity of sepsis was assessed. Surviving patients without diabetes at discharge were followed-up for 5 years to investigate risk for development of diabetes.
Hyperglycemia was related to severity of sepsis. Follow-up was finished for 55 patients with hyperglycemia, of which 8 (15.7%) developed diabetes, and 118 patients with normoglycemia, of which 5 (4.2%) developed diabetes (P = .002). Relative risk for developing type 2 diabetes was 4.29 (95% CI, 1.35-13.64).
Patients with hyperglycemia in sepsis who are not diagnosed with diabetes before or during the hospitalization should be considered a population at increased risk for developing diabetes.
即使在没有糖尿病或糖代谢受损的患者中，脓毒症也常伴有高血糖。它是炎症反应和应激的结果，因此其发生与疾病严重程度有关。然而，并非所有重病患者都会发生高血糖，有些患者即使在轻症疾病中也会发生高血糖。我们假设存在糖代谢的潜在障碍，这有助于高血糖的发生，并且这些患者可能有更高的糖尿病风险。
纳入患有脓毒症且无糖代谢受损史的患者，并分为高血糖组（血糖>7.8mmol/L）和正常血糖组。评估脓毒症的严重程度。出院时无糖尿病的存活患者进行了 5 年的随访，以调查发生糖尿病的风险。
高血糖与脓毒症的严重程度有关。对 55 例高血糖患者进行了随访，其中 8 例（15.7%）发生了糖尿病，118 例正常血糖患者中，有 5 例（4.2%）发生了糖尿病（P=0.002）。发生 2 型糖尿病的相对风险为 4.29（95%CI，1.35-13.64）。
脓毒症中高血糖且在住院前或住院期间未被诊断为糖尿病的患者应被视为发生糖尿病风险增加的人群。
