title: Impact of diabetes mellitus and its complications: survival and quality-of-life in critically ill patients.
abstract: OBJECTIVE
  Diabetes mellitus represents an increasing problem for patients and health care systems worldwide. We sought to investigate the effect of diabetes and its associated comorbidities on long-term survival and quality of life following an admission to a medical intensive care unit (ICU).
  
  
  METHODS
  A total of 6662 consecutive patients admitted to ICU between 2004 and 2009 were included (patients with diabetes n=796, non-diabetic patients n=5866). The primary endpoint of the study was death of any cause. Data on mortality was collected upon review of medical records or phone interviews. Moreover, a questionnaire was sent to 500 randomly selected patients addressing Health related Quality of Life (HrQoL) after ICU treatment.
  
  
  RESULTS
  Overall mortality did not differ significantly between diabetic and non-diabetic patients after ICU treatment (mean follow-up time: 490 days). For a subgroup of patients already exhibiting comorbidities associated with diabetes, the mortality rate was significantly higher (p=0.022). Regarding quality of life, no differences were found between groups.
  
  
  CONCLUSIONS
  Diabetes was not associated with increased mortality or reduced quality of life in a general population of medical ICU patients. However, once comorbidities associated with diabetes occurred, the survival rate of patients with comorbidities associated with hyperglycemia was significantly reduced.
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Bannier
authors.affiliation: University Clinic of Internal Medicine II, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Lichtenauer
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Franz
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Fritzenwanger
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Bjoern
authors.initials: B
authors.lastname: Kabisch
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Hans-Reiner
authors.initials: HR
authors.lastname: Figulla
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany.
authors.forename: Ruediger
authors.initials: R
authors.lastname: Pfeifer
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine I, Jena, Germany. Electronic address: christian.jung@med.uni-jena.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009026:Mortality; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D062606:Tertiary Care Centers
keywords: Critically ill; Diabetes mellitus; Follow-up; Intensive care; Quality of life