Hyperglycemia in sepsis is a risk factor for development of type II diabetes.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Gornik
Ivan
I
Department of Intensive Care Medicine, University Hospital Centre Rebro, Zagreb 10000, Croatia. ivan.gornik@gmail.com
Vujaklija
Ana
A
Lukić
Edita
E
Madzarac
Goran
G
Gasparović
Vladimir
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D012720:Severity of Illness Index; D055815:Young Adult