Skip to main content
Erschienen in: Critical Care 2/2010

01.04.2010 | Commentary

Patients with diabetes in the intensive care unit; not served by treatment, yet protected?

verfasst von: Sarah E Siegelaar, J Hans Devries, Joost B Hoekstra

Erschienen in: Critical Care | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Diabetes is associated with severe complications and decreased life expectancy. However, in the previous issue of Critical Care, Vincent and colleagues report no difference in mortality between patients with insulin-treated diabetes and patients without diabetes in the intensive care unit (ICU), despite larger severity of illness in the diabetes group at admission. This study contributes to the growing evidence that diabetes in itself is not a risk factor for ICU mortality, although the mechanisms are not yet fully understood. On the other hand, patients with diabetes seem not to benefit from tight glycemic control during their ICU stay. Different treatment approaches may be needed for patients with diabetes and patients with stress hyperglycemia.
Literatur
1.
Zurück zum Zitat Vincent J, Preiser J, Sprung C, Moreno R, Sakr Y: Insulin-treated diabetes is not associated with increased mortality in critically ill patients. Crit Care 2010, 14: R12. 10.1186/cc8866PubMedCentralCrossRefPubMed Vincent J, Preiser J, Sprung C, Moreno R, Sakr Y: Insulin-treated diabetes is not associated with increased mortality in critically ill patients. Crit Care 2010, 14: R12. 10.1186/cc8866PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Brown JR, Edwards FH, O'Connor GT, Ross CS, Furnary AP: The diabetic disadvantage: historical outcomes measures in diabetic patients undergoing cardiac surgery -- the pre-intravenous insulin era. Semin Thorac Cardiovasc Surg 2006, 18: 281-288. 10.1053/j.semtcvs.2006.04.004CrossRefPubMed Brown JR, Edwards FH, O'Connor GT, Ross CS, Furnary AP: The diabetic disadvantage: historical outcomes measures in diabetic patients undergoing cardiac surgery -- the pre-intravenous insulin era. Semin Thorac Cardiovasc Surg 2006, 18: 281-288. 10.1053/j.semtcvs.2006.04.004CrossRefPubMed
3.
Zurück zum Zitat Slynkova K, Mannino DM, Martin GS, Morehead RS, Doherty DE: The role of body mass index and diabetes in the development of acute organ failure and subsequent mortality in an observational cohort. Crit Care 2006, 10: R137. 10.1186/cc5051PubMedCentralCrossRefPubMed Slynkova K, Mannino DM, Martin GS, Morehead RS, Doherty DE: The role of body mass index and diabetes in the development of acute organ failure and subsequent mortality in an observational cohort. Crit Care 2006, 10: R137. 10.1186/cc5051PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Graham BB, Keniston A, Gajic O, Trillo Alvarez CA, Medvedev S, Douglas IS: Diabetes mellitus does not adversely affect outcomes from a critical illness. Crit Care Med 2010, 38: 16-24. 10.1097/CCM.0b013e3181b9eaa5CrossRefPubMed Graham BB, Keniston A, Gajic O, Trillo Alvarez CA, Medvedev S, Douglas IS: Diabetes mellitus does not adversely affect outcomes from a critical illness. Crit Care Med 2010, 38: 16-24. 10.1097/CCM.0b013e3181b9eaa5CrossRefPubMed
5.
Zurück zum Zitat Pittet D, Thievent B, Wenzel RP, Li N, Gurman G, Suter PM: Importance of pre-existing co-morbidities for prognosis of septicemia in critically ill patients. Intensive Care Med 1993, 19: 265-272. 10.1007/BF01690546CrossRefPubMed Pittet D, Thievent B, Wenzel RP, Li N, Gurman G, Suter PM: Importance of pre-existing co-morbidities for prognosis of septicemia in critically ill patients. Intensive Care Med 1993, 19: 265-272. 10.1007/BF01690546CrossRefPubMed
6.
Zurück zum Zitat Stegenga ME, Vincent JL, Vail GM, Xie J, Haney DJ, Williams MD, Bernard GR, Poll T: Diabetes does not alter mortality or hemostatic and inflammatory responses in patients with severe sepsis. Crit Care Med 2010, 38: 539-545. 10.1097/CCM.0b013e3181c02726CrossRefPubMed Stegenga ME, Vincent JL, Vail GM, Xie J, Haney DJ, Williams MD, Bernard GR, Poll T: Diabetes does not alter mortality or hemostatic and inflammatory responses in patients with severe sepsis. Crit Care Med 2010, 38: 539-545. 10.1097/CCM.0b013e3181c02726CrossRefPubMed
7.
Zurück zum Zitat Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le G Jr, Payen D: Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006, 34: 344-353. 10.1097/01.CCM.0000194725.48928.3ACrossRefPubMed Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le G Jr, Payen D: Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006, 34: 344-353. 10.1097/01.CCM.0000194725.48928.3ACrossRefPubMed
8.
Zurück zum Zitat Michalia M, Kompoti M, Koutsikou A, Paridou A, Giannopoulou P, Trikka-Graphakos E, Clouva-Molyvdas P: Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections. Intensive Care Med 2009, 35: 448-454. 10.1007/s00134-008-1288-0CrossRefPubMed Michalia M, Kompoti M, Koutsikou A, Paridou A, Giannopoulou P, Trikka-Graphakos E, Clouva-Molyvdas P: Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections. Intensive Care Med 2009, 35: 448-454. 10.1007/s00134-008-1288-0CrossRefPubMed
9.
Zurück zum Zitat Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K, EPIC II Group of Investigators: International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009, 302: 2323-2329. 10.1001/jama.2009.1754CrossRefPubMed Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K, EPIC II Group of Investigators: International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009, 302: 2323-2329. 10.1001/jama.2009.1754CrossRefPubMed
10.
Zurück zum Zitat Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C, Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators: Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005, 294: 813-818. 10.1001/jama.294.7.813CrossRefPubMed Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C, Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators: Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005, 294: 813-818. 10.1001/jama.294.7.813CrossRefPubMed
11.
Zurück zum Zitat Moss M, Guidot DM, Steinberg KP, Duhon GF, Treece P, Wolken R, Hudson LD, Parsons PE: Diabetic patients have a decreased incidence of acute respiratory distress syndrome. Crit Care Med 2000, 28: 2187-2192. 10.1097/00003246-200007000-00001CrossRefPubMed Moss M, Guidot DM, Steinberg KP, Duhon GF, Treece P, Wolken R, Hudson LD, Parsons PE: Diabetic patients have a decreased incidence of acute respiratory distress syndrome. Crit Care Med 2000, 28: 2187-2192. 10.1097/00003246-200007000-00001CrossRefPubMed
12.
Zurück zum Zitat Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Hegarty C, Bailey M: Blood glucose concentration and outcome of critical illness: the impact of diabetes. Crit Care Med 2008, 36: 2249-2255. 10.1097/CCM.0b013e318181039aCrossRefPubMed Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Hegarty C, Bailey M: Blood glucose concentration and outcome of critical illness: the impact of diabetes. Crit Care Med 2008, 36: 2249-2255. 10.1097/CCM.0b013e318181039aCrossRefPubMed
13.
Zurück zum Zitat Whitcomb BW, Pradhan EK, Pittas AG, Roghmann MC, Perencevich EN: Impact of admission hyperglycemia on hospital mortality in various intensive care unit populations. Crit Care Med 2005, 33: 2772-2777. 10.1097/01.CCM.0000189741.44071.25CrossRefPubMed Whitcomb BW, Pradhan EK, Pittas AG, Roghmann MC, Perencevich EN: Impact of admission hyperglycemia on hospital mortality in various intensive care unit populations. Crit Care Med 2005, 33: 2772-2777. 10.1097/01.CCM.0000189741.44071.25CrossRefPubMed
14.
Zurück zum Zitat Berghe G, Wilmer A, Milants I, Wouters PJ, Bouckaert B, Bruyninckx F, Bouillon R, Schetz M: Intensive insulin therapy in mixed medical/surgical intensive care units. Diabetes 2006, 55: 3151-3159. 10.2337/db06-0855CrossRefPubMed Berghe G, Wilmer A, Milants I, Wouters PJ, Bouckaert B, Bruyninckx F, Bouillon R, Schetz M: Intensive insulin therapy in mixed medical/surgical intensive care units. Diabetes 2006, 55: 3151-3159. 10.2337/db06-0855CrossRefPubMed
15.
Zurück zum Zitat Garg R, Chaudhuri A, Munschauer F, Dandona P: Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006, 37: 267-273. 10.1161/01.STR.0000195175.29487.30CrossRefPubMed Garg R, Chaudhuri A, Munschauer F, Dandona P: Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke 2006, 37: 267-273. 10.1161/01.STR.0000195175.29487.30CrossRefPubMed
16.
Zurück zum Zitat Peake SL, Moran JL, Ghelani DR, Lloyd AJ, Walker MJ: The effect of obesity on 12-month survival following admission to intensive care: a prospective study. Crit Care Med 2006, 34: 2929-2939.PubMed Peake SL, Moran JL, Ghelani DR, Lloyd AJ, Walker MJ: The effect of obesity on 12-month survival following admission to intensive care: a prospective study. Crit Care Med 2006, 34: 2929-2939.PubMed
17.
Zurück zum Zitat Motoyama T, Okamoto K, Kukita I, Hamaguchi M, Kinoshita Y, Ogawa H: Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome. Crit Care Med 2003, 31: 1048-1052. 10.1097/01.CCM.0000055371.27268.36CrossRefPubMed Motoyama T, Okamoto K, Kukita I, Hamaguchi M, Kinoshita Y, Ogawa H: Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome. Crit Care Med 2003, 31: 1048-1052. 10.1097/01.CCM.0000055371.27268.36CrossRefPubMed
Metadaten
Titel
Patients with diabetes in the intensive care unit; not served by treatment, yet protected?
verfasst von
Sarah E Siegelaar
J Hans Devries
Joost B Hoekstra
Publikationsdatum
01.04.2010
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 2/2010
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8881

Weitere Artikel der Ausgabe 2/2010

Critical Care 2/2010 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Delir bei kritisch Kranken – Antipsychotika versus Placebo

16.05.2024 Delir Nachrichten

Um die Langzeitfolgen eines Delirs bei kritisch Kranken zu mildern, wird vielerorts auf eine Akuttherapie mit Antipsychotika gesetzt. Eine US-amerikanische Forschungsgruppe äußert jetzt erhebliche Vorbehalte gegen dieses Vorgehen. Denn es gibt neue Daten zum Langzeiteffekt von Haloperidol bzw. Ziprasidon versus Placebo.

Eingreifen von Umstehenden rettet vor Erstickungstod

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.