scholarly journals Association between blood glucose levels in insulin therapy and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

2021 ◽  
Author(s):  
Tao Yuan ◽  
Hongyu He ◽  
Yuepeng Liu ◽  
Jianwei Wang ◽  
Xin Kang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Insulin Therapy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Medium Level ◽  
Level Group

Abstract Background: Too high or low blood glucose levels after traumatic brain injury (TBI) negatively affect the prognosis of patients with TBI. This study aimed to examine the relationship between different levels of blood glucose in insulin therapy and Glasgow Outcome Score (GOS) in patients with TBI.Methods: This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. The information on disease, lab examination, insulin therapy, and operation of patients with TBI was collected. Also, the data on 5-year and 6-month GOS were collected as primary and secondary outcomes. The univariate analysis was used to detect variables that might contribute to outcomes, while the multivariate regression analysis was used to reveal the independent relationship between insulin therapy and outcomes. A generalized additive model (GAM) was used to investigate dose–response relationships between blood glucose levels and GOS. The results were presented as odds ratios (ORs) with their 95% confidence intervals (95% CIs). We further applied a two-piecewise linear regression model to examine the threshold effect of blood glucose level and GOS.Results: A total of 182 patients were involved in the final analysis. Compared with the non-intensive insulin therapy group, the 5-year GOS in the moderate-control intensive insulin therapy (IIT) group and the slight-control IIT group was 1.45 and 1.39 higher, respectively (both P < 0.05); the 5-year GOS in the strict-control IIT group was 0.23 higher (P > 0.05). GAM revealed that a bell-shaped relationship existed between blood glucose levels in insulin therapy and 5-year or 6-month GOS. The inflection points of the mean blood glucose level were 6.73 and 8.97 mmol/L considering 5-year GOS as the outcome and were 6.95 and 8.88 mmol/L considering 6-month GOS as the outcome. The multivariate analysis showed that the 5-year GOS in the medium-level group (≥6.73 and <8.97 mmol/L) increased by 0.83 [95% confidence interval (CI): 0.22–1.47] compared with that in the low-level group (<6.73 mmol/L). Also, the 5-year GOS in the medium-level group increased by 0.57 (95% CI: 0.02–1.08) compared with that in the high-level group (≥8.97 mmol/L).Conclusion: A proper blood glucose range in insulin therapy could improve the outcomes of patients with TBI; the range was 6.73–8.97 mmol/L according to our limited analysis.Clinical Trial Registration: ClinicalTrials.gov, NCT02161055. Registered 11 Jun 2014.

scholarly journals Association between blood glucose levels and Glasgow Outcome Score in patients with traumatic brain injury: secondary analysis of a randomized trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Tao Yuan ◽  
Hongyu He ◽  
Yuepeng Liu ◽  
Jianwei Wang ◽  
Xin Kang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Threshold Effect ◽  
Glasgow Outcome Score ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Average Blood Glucose

Abstract Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.

scholarly journals Differential temporal profile of lowered blood glucose levels (3.5 - 6.5 mM versus 5 - 8 mM) in patients with severe traumatic brain injury

Critical Care ◽  
2008 ◽  
Vol 12 (4) ◽  
pp. R98 ◽  
Author(s):  
Regula Meier ◽  
Markus Bechir ◽  
Silke Ludwig ◽  
Jutta Sommerfeld ◽  
Marius Keel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Temporal Profile ◽  
Glucose Levels ◽  
Blood Glucose Levels

Glycemic Control in Neurocritically Ill Patients

2019 ◽  
pp. 241-245
Author(s):  
Carla P. Venegas-Borsellino ◽  
Michael A. Pizzi ◽  
Santiago Naranjo-Sierra
Keyword(s):  
Traumatic Brain Injury ◽  
Ischemic Stroke ◽  
Blood Glucose ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Glycemic Control ◽  
Adverse Outcomes ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Poor Outcomes

Hyperglycemia, hypoglycemia, and variable blood glucose levels are associated with poor outcomes in critically ill patients. Patients with acute brain injury are sensitive to changes in glycemic levels because brain metabolism depends on a continuous, reliable supply of glucose. Numerous studies have shown that even moderate hypoglycemia may cause pronounced neuroglycopenia. Conversely hyperglycemia, which is prevalent in neurocritically ill patients, has been related to adverse outcomes after traumatic brain injury, ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage.

Association between Blood Glucose Levels the Day after Targeted Temperature Initiation and Outcome in Traumatic Brain Injury: APost-HocAnalysis of the B-HYPO Study

2017 ◽  
Vol 34 (5) ◽  
pp. 987-995 ◽  
Author(s):  
Hitoshi Kobata ◽  
Akira Sugie ◽  
Eiichi Suehiro ◽  
Kenji Dohi ◽  
Tadashi Kaneko ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Glucose Levels ◽  
Blood Glucose Levels

scholarly journals EFFECTIVENESS OF AMLA JUICE IN REDUCING BLOOD GLUCOSE LEVEL AMONG PATIENTS WITH TYPE II DIABETES IN A SELECTED AREA OF KANYAKUMARI DISTRICT

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mrs. Vanitha. S s ◽  
Dr. Pramjit kaur
Keyword(s):  
Blood Glucose ◽  
Standard Deviation ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Type Ii Diabetes ◽  
Control Group ◽  
Type Ii ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Experimental Group

Challenges in lifestyle, such as increasesin energy intake and decreasesin physical activity are causing overweight and obesity leading to epidemic increases in type II Diabetes Mellitus. The research approach used for this study was evaluative approach and the research design was true experimental design. 60 patients with type II diabetes, 30 in experimental group and 30 in control group were selected for this study by using purposive sampling technique. Data was collected with the help of self-structured interview schedule. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (chi-square, paired ‘t’ test) were used to analyse the data and to test the hypotheses. In the experimental group,the pre-test mean score was 2.966, mean percentage was 59% and standard deviation was 1.129 and in post-testmean score was 2.533, mean percentage was 50.66% and standard deviation was 1.074 with effectiveness of 8.34% and paired‘t’ test value of t=3.971,which was statistically significant (p<0.05) which is an evidence ofthe effectiveness of Amla juice in reducing blood glucose level. Comparison of blood glucose levels in experimental and control groups, shows that the value is statistically highly significant, as was observed from the unpaired ‘t’ test value of 13.39 with P value of <0.05, which is an evidence indicatingthe effect of Amla juice in reducing postprandial blood glucose levels. The resultsfound that the administration of Amla juice did have aneffect in reducing blood glucose level in the experimental group. By comparing the findings of pre-test and post test between the experimental group and the control group,the effect was identified (assessed). The study concluded that the Amlajuice is effective in reducing blood glucose level.

scholarly journals Comparison of Functional Regression and Functional Principal Component Regression for Estimating Non-Invasive Blood Glucose Level

2021 ◽  
Vol 5 (1) ◽  
pp. 14-25
Author(s):  
Nurul Fadhilah ◽  
Erfiani Erfiani ◽  
Indahwati Indahwati
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Principal Component Regression ◽  
Principal Component ◽  
Functional Regression ◽  
Glucose Levels ◽  
Non Invasive ◽  
Blood Glucose Levels ◽  
Functional Principal Component

The calibration method is an alternative method that can be used to analyze the relationship between invasive and non-invasive blood glucose levels. Calibration modeling generally has a large dimension and contains multicolinearities because usually in functional data the number of independent variables (p) is greater than the number of observations (p>n). Both problems can be overcome using Functional Regression (FR) and Functional Principal Component Regression (FPCR). FPCR is based on Principal Component Analysis (PCA). In FPCR, the data is transformed using a polynomial basis before data reduction. This research tried to model the equations of spectral calibration of voltage value excreted by non-invasive blood glucose level monitoring devices to predict blood glucose using FR and FPCR. This study aimed to determine the best calibration model for measuring non-invasive blood glucose levels with the FR and FPCR. The results of this research showed that the FR model had a bigger coefficient determination (R2) value and lower Root Mean Square Error (RMSE) and Root Mean Square Error Prediction (RMSEP) value than the FPCR model, which was 12.9%, 5.417, and 5.727 respectively. Overall, the calibration modeling with the FR model is the best model for estimate blood glucose level compared to the FPCR model.

Intensive Insulin Therapy and Pentastarch Resuscitation in Sepsis

2018 ◽  
pp. 109-113
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Blood Glucose ◽  
Insulin Therapy ◽  
Fluid Resuscitation ◽  
Intensive Insulin Therapy ◽  
Safety And Efficacy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Ringer’S Lactate

This case focuses on the use of intensive insulin therapy with sepsis by asking the question: What are the safety and efficacy of intensive insulin therapy compared with conventional therapy and hydroxyethyl starch (HES) compared with Ringer’s lactate in patients with severe sepsis or septic shock? This study demonstrated that critically ill patients did not benefit from intensive insulin therapy targeting blood glucose levels of 80–110 mg/dL vs. conventional insulin therapy nor from fluid resuscitation with HES vs. Ringer’s lactate. Neither intensive insulin therapy nor fluid resuscitation with HES is currently recommended in major sepsis guidelines.

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