title: Hyperglycemia and glycemic variability are associated with the severity of sepsis in nondiabetic subjects.
abstract: The purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients.
  
  
  
  Nondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours. Sepsis severity was evaluated with the Sepsis-related Organ Failure Assessment Score (SOFA). MGL and GV in patients with SOFA ≥9 and <9 were compared.
  
  
  
  Thirty nondiabetic sepsis and 10 healthy subjects were recruited. No differences were found between groups except for higher patient age in sepsis patients. The MGL and MAGE72hof sepsis patients were significantly higher than those of healthy subjects. MGL and GV24hwere higher in patients with SOFA ≥9 than in patients with SOFA <9 (MGL24h195±17 vs 139±27, P<.001; SD24h32 [28, 36] vs 19 [5, 58], P=.02; and MAGE24h94 [58, 153] vs 54 [16, 179], P=.01).
  
  
  
  Nondiabetic sepsis patients had higher MGL and GV values than healthy subjects. MGL and GV24hwere associated with sepsis severity.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
authors.forename: Lukana
authors.initials: L
authors.lastname: Preechasuk
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
authors.forename: Nattakarn
authors.initials: N
authors.lastname: Suwansaksri
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
authors.forename: Nantawan
authors.initials: N
authors.lastname: Ipichart
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
authors.forename: Sathit
authors.initials: S
authors.lastname: Vannasaeng
authors.affiliation: Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700.
authors.forename: Chairat
authors.initials: C
authors.lastname: Permpikul
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, 10700. Electronic address: apiradeesi99@hotmail.com.
authors.forename: Apiradee
authors.initials: A
authors.lastname: Sriwijitkamol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D063305:Organ Dysfunction Scores; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose
keywords: Continuous glucose monitoring; Glycemic variability; Mean amplitude of glycemic excursion; Sepsis