1 Epidemiology and Research Unit, E. Wolfson Medical Center , Holon, Israel .
Diabetes Technol Ther. 2013 Nov;15(11):964-7. doi: 10.1089/dia.2013.0035. Epub 2013 Jul 16.
Acute physiological stress has been shown to impair glucose homeostasis. War is a period of acute psychological stress, and its effect on glucose control is unknown. In this study random point-of-care (POC) glucose levels were measured using an automated, institutional glucometer in hospitalized adult patients prior to versus during the Israeli Pillar of Defense campaign (November 7-10, 2012).
Random POC glucose values measured with the institutional blood glucose monitoring system were obtained 1 week prior to the Pillar of Defense campaign (November 7-10, 2012) and compared with values to those obtained during the first 4 days of the war (November 14-17, 2012).
In total, 3,573 POC glucose measures were included: 1,865 during the pre-war period and 1,708 during the campaign. POC glucose measures were significantly higher during the war compared with the week preceding the war: 9.7±4.7 versus 9.3±4.2 mmol/L (P=0.02). In a general linear model, period (pre-war vs. during war) persisted as a significant predictor of POC glucose even after controlling for age, sex, and department type (internal medicine vs. surgical).
Acute stress, such as a wartime situation, is associated with a significant increase in random blood glucose values in a population of hospitalized adults. Long-term follow-up of the individuals hospitalized during these two periods can reveal differences in morbidity and mortality trends.
急性生理应激已被证明会损害血糖稳态。战争是一段急性心理压力时期,其对血糖控制的影响尚不清楚。在这项研究中,在以色列“护柱行动”(2012 年 11 月 7 日至 10 日)之前和期间,使用机构内自动即时血糖仪对住院成年患者进行了随机即时血糖(POC)测量。
在“护柱行动”之前一周(2012 年 11 月 7 日至 10 日)和战争的前 4 天(2012 年 11 月 14 日至 17 日)期间,分别用机构血糖监测系统测量随机 POC 血糖值,并将其与值进行比较。
共纳入 3573 次 POC 血糖测量值:1865 次在战前期间,1708 次在战争期间。与战前一周相比,战争期间的 POC 血糖值明显升高:9.7±4.7 与 9.3±4.2mmol/L(P=0.02)。在一般线性模型中,即使在控制年龄、性别和科室类型(内科与外科)后,时期(战前与战争期间)仍然是 POC 血糖的显著预测因素。
急性应激,如战时情况,与住院成年人群中随机血糖值的显著升高有关。对这两个时期住院的个体进行长期随访,可以揭示发病率和死亡率趋势的差异。