Glucose Intolerance in Intensive Care Patients: Incidence and Outcome
Abstract Introduction Critical illness is associated with modification in metabolic status. Insulin resistance and elevated blood glucose levels occur during stressful conditions. Objective to evaluate the incidence and outcome of glucose intolerance in intensive care. Patients and method This prospective clinical study included 290 patients, admitted to intensive care unit (ICU), from December 2018 to January 2020. They were divided into three groups according to maximum blood glucose level during the initial 48 hours of admission: Normoglycemic, hyperglycemic and hypoglycemic. Each group was subdivided into: known diabetic and not known diabetic. Patients’ age, sex, APACHI II, admission diagnosis were recorded. Blood glucose level was followed every six hours; high blood glucose during first 48 hours of admission was defined as acute hyperglycemia. Use of vasopressor and corticosteroid therapy, type of feeding, days on mechanical ventilation, total days of stay in ICU, and fate of patients were recorded. Results Hyperglycemia was common with critical illness. Its incidence was 45.5 % and 67.2% on ICU admission and during 48 hours. after admission respectively;. Of them, 51% were diabetics, while 16.2% were non diabetics. Hyperglycemia was associated with increased morbidity in the form of difficult weaning from mechanical ventilation and long ICU stay. Of hyperglycemic patients, 66.4 % were orally fed.Mortality among normoglycemic patients was 37.5 %; slightly lower than mortality among hyperglycemic patients (39.2%), but without statistical significant difference. Glucose intolerance in critically ill patients was not related to severity of the disease or cause of admission and vasopressors and steroids were not risk factors for glucose intolerance during the initial 48 hrs. of admission Conclusion Glucose intolerance is high in intensive care patients and is associated with high morbidity and mortality.