title: Institutional point-of-care glucometer identifies population trends in blood glucose associated with war.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Epidemiology and Research Unit, E. Wolfson Medical Center , Holon, Israel .
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Zipora
authors.initials: Z
authors.lastname: Matas
authors.forename: Tova
authors.initials: T
authors.lastname: Chaimy
authors.forename: Zohar
authors.initials: Z
authors.lastname: Landau
authors.forename: Yosefa
authors.initials: Y
authors.lastname: Bar Dayan
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Berlovitz
authors.forename: Julio
authors.initials: J
authors.lastname: Wainstein
mesh_terms: D017677:Age Distribution; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D019719:Diagnostic Equipment; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000378:metabolism*; D007003:Hypoglycemia / Q000453:epidemiology / Q000378:metabolism*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D019095:Point-of-Care Systems / Q000639:trends; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D017678:Sex Distribution; D013315:Stress, Psychological / Q000378:metabolism*; D014857:Warfare
chemical_list: D001786:Blood Glucose