title: The diabetes paradox: diabetes is not independently associated with mortality in critically ill patients.
abstract: Intensive monitoring of blood glucose levels and treatment of hyperglycemia in critically ill patients has become a standard of care over the past decade. Although diabetes is associated with a large burden of illness in outpatients, the "diabetes paradox" suggests that in patients admitted to intensive care units, the presence of diabetes as a comorbidity is not independently associated with increased risk of mortality. This review article 1) describes prospective trial and observational cohort literature addressing this issue, 2) addresses the potential mechanisms underlying the diabetes paradox, and 3) discusses implications for patient care and future research.
authors.affiliation: Director of Critical Care, Stamford Hospital, Stamford, CT; Clinical Professor of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. jkrinsley@stamhealth.org.
authors.forename: James S
authors.initials: JS
authors.lastname: Krinsley
authors.forename: Molly
authors.initials: M
authors.lastname: Fisher
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015897:Comorbidity; D016638:Critical Illness / Q000401:mortality*; D003920:Diabetes Mellitus / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D064887:Observational Studies as Topic; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose