Malglycemia in the critical care setting. Part II: Relative and absolute hypoglycemia
Authors' conclusion
Relative hypoglycemia represented by excursions below GR 0.7 in those with HbA1c ≥ 8% occurred commonly and was independently associated with mortality. Absolute hypoglycemia had similar association with mortality regardless of HbA1c.
Study context
- Population
- Critically ill patients
- Participants
- 4,790 patients
- Exposure
- Relative hypoglycemia and absolute hypoglycemia by HbA1c
- HbA1c ≥ 8%n = 373
- HbA1c < 8%n = 4,417
- Outcome
- Hospital mortality
Methodological detailsrisk-adjusted
- Risk-adjusted
Main finding
As reported in the abstract
Hospital mortality with excursions below GR 0.7 (24-h non-exposure period between excursions)
Odds ratio (95% CI)P value
HbA1c ≥ 8%independently associated
2.49(1.54–4.04)
P = 0.0002HbA1c < 8%not associated
0.98(0.89–1.08)
P = 0.70Observational data: associations, not effects.
Further findings
Mortality with exposure to BG < 70 mg/dL, HbA1c ≥ 6.5% vs <6.5% (subgroup) · no difference
P = 0.77
Hours below Glycemic Ratio (GR) 0.7 and minimum GR
- Hours below GR 0.7: not independently associated with outcome
- 1.0037, 0.9995-1.0080, 0.0846
- Minimum GR: not independently associated with outcome
- 0.0896, 0.0030-2.6600, 0.1632
Absolute hypoglycemia measures
- Absolute hypoglycemia occurred across the HbA1c spectrum in a U-shaped pattern
- Hours below 70 mg/dL strongest association with outcome; minimum blood glucose (BG) and excursions below 70 mg/dL also independently associated
Original publication
Malglycemia in the critical care setting. Part II: Relative and absolute hypoglycemia. J Crit Care. Published 13 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →