Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: A systematic review and meta-analysis

Yasmine Ali Abdelhamid, Palash Kar, Mark E. Finnis, Liza K. Phillips, Mark P. Plummer, Jonathan E. Shaw, Michael Horowitz, Adam M. Deane

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. Methods: We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 % CIs for the occurrence of diabetes were calculated using a random-effects model. Results: Four cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 % CI 2.02-5.98; I 2 = 36.5 %). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied. Conclusions: Stress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.

Original languageEnglish
Article number301
JournalCritical Care
Volume20
Issue number1
DOIs
Publication statusPublished - 27 Sep 2016
Externally publishedYes

Keywords

  • Blood glucose
  • Critical care
  • Hyperglycaemia
  • Meta-analysis
  • Prediabetes
  • Type 2 diabetes mellitus

Cite this

Ali Abdelhamid, Yasmine ; Kar, Palash ; Finnis, Mark E. ; Phillips, Liza K. ; Plummer, Mark P. ; Shaw, Jonathan E. ; Horowitz, Michael ; Deane, Adam M. / Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes : A systematic review and meta-analysis. In: Critical Care. 2016 ; Vol. 20, No. 1.
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title = "Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: A systematic review and meta-analysis",
abstract = "Background: Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. Methods: We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 {\%} CIs for the occurrence of diabetes were calculated using a random-effects model. Results: Four cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 {\%} CI 2.02-5.98; I 2 = 36.5 {\%}). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied. Conclusions: Stress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.",
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Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes : A systematic review and meta-analysis. / Ali Abdelhamid, Yasmine; Kar, Palash; Finnis, Mark E.; Phillips, Liza K.; Plummer, Mark P.; Shaw, Jonathan E.; Horowitz, Michael; Deane, Adam M.

In: Critical Care, Vol. 20, No. 1, 301, 27.09.2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes

T2 - A systematic review and meta-analysis

AU - Ali Abdelhamid, Yasmine

AU - Kar, Palash

AU - Finnis, Mark E.

AU - Phillips, Liza K.

AU - Plummer, Mark P.

AU - Shaw, Jonathan E.

AU - Horowitz, Michael

AU - Deane, Adam M.

PY - 2016/9/27

Y1 - 2016/9/27

N2 - Background: Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. Methods: We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 % CIs for the occurrence of diabetes were calculated using a random-effects model. Results: Four cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 % CI 2.02-5.98; I 2 = 36.5 %). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied. Conclusions: Stress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.

AB - Background: Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. Methods: We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 % CIs for the occurrence of diabetes were calculated using a random-effects model. Results: Four cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 % CI 2.02-5.98; I 2 = 36.5 %). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied. Conclusions: Stress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.

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