title: Effect of type II diabetes mellitus on outcomes in patients with acute respiratory distress syndrome.
abstract: OBJECTIVE
  The acute respiratory distress syndrome (ARDS) is a life-threatening condition, whereas the presence of diabetes has been shown to be protective in its development. We undertook this study to assess the association of type II diabetes mellitus with clinical outcomes in patients with ARDS.
  
  
  METHODS
  We retrospectively examined the medical records of consecutive series of patients with ARDS requiring mechanical ventilation from January 2008 to March 2011. Patients with type I diabetes were excluded from the study. Clinical outcomes such as ventilator-free days, mortality, length of stay in the hospital and intensive care unit (ICU), and reintubations were compared based on the presence of diabetes. Multivariate regression model was used to find if the presence of type II diabetes mellitus predicts ventilator-free days at day 28.
  
  
  RESULTS
  Two hundred forty-nine patients with ARDS were admitted to the ICU during the study period. Fifty (20%) subjects had type II diabetes mellitus. Differences in ventilator-free days, in-hospital mortality, reintubation rate, and length of stay in the hospital or ICU were not statistically significant between diabetic and nondiabetic patients with ARDS. Acute Physiologic and Chronic Health Evaluation II, ICU specialty, use of vasopressors, and the need for reintubation were predictors of ventilator-free days at day 28. The presence of type II diabetes mellitus and its adjustment by body mass index did not show association with ventilator-free days at day 28.
  
  
  CONCLUSIONS
  The presence of type II diabetes mellitus is not associated with clinical outcomes in ARDS, even when its presence is adjusted by body mass index.
authors: Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA.
authors: Abhishek
authors: A
authors: Singla
authors: Division of Clinical Research and Evaluative Sciences, Creighton University School of Medicine, Omaha, NE, USA.
authors: Paul
authors: P
authors: Turner
authors: Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA.
authors: Madhu Kalyan
authors: MK
authors: Pendurthi
authors: Division of Endocrinology, Baylor College of Medicine, Houston, TX, USA.
authors: Vrinda
authors: V
authors: Agrawal
authors: Intensive Care Unit and Respiratory Care Services, Pulmonary, Sleep and Critical Care Medicine Division, Creighton University School of Medicine, Omaha, NE, USA. Electronic address: arielmodrykamien@creighton.edu.
authors: Ariel
authors: A
authors: Modrykamien
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents
keywords: ACE-I; ALI; APACHE; ARDS; Acute Physiologic and Chronic Health Evaluation; Acute lung injury; Acute respiratory distress syndrome; BMI; Body mass index; DM; Diabetes mellitus; ICU; LIPS; LOS; Lung Injury Prediction Score; T2DM; Ventilator-free days; acute lung injury; acute respiratory distress syndrome; angiotensin-converting enzyme inhibitor; body mass index; diabetes mellitus; intensive care unit; length of stay; type II diabetes mellitus