The Value behind Your Glucose Knowledge

How much do blood glucose levels matter for hospitalized patients with or without pre-existing diabetes? Glucose-Blog-Image-01-29-16

Immensely, for patients with a full spectrum of acute heart failure syndromes (AHFSs), according to a recent European Heart Journal (EHJ) study. The study found that even mildly elevated blood glucose was associated with early death and future diabetes complications as well as hospitalizations for both patient populations.

Too often, the importance of optimal blood glucose levels in patients with heart failure (HF) is overlooked, particularly for those without a prior history of diabetes. Although the association of myocardial infarction (MI) and hyperglycemia with early death is well recognized, the EHJ study is one of the first studies to show the impact of high blood sugar on a broader spectrum of AHFS conditions, and a connection with future diabetes complications.

The EHJ study examined a large cohort of 16,524 AHFS patients entering the emergency department (ED) in Ontario, Canada during a three year period. Notably, these patients comprise a significant proportion of those admitted to the ED.  Moreover, up to 40% of all AHFS patients may be hyperglycemic, regardless of pre-existing diabetes status.

Diabetes, Hospitalization, Death

Researchers conducted a competing risk analysis for 30-day mortality, new diabetes diagnoses and hospitalization outcomes. For patients without prior diabetes, modestly elevated blood glucose (>6.1 mmol/L) on hospital admission correlated with elevated risks of early all-cause and cardiovascular mortality as well as de novo diabetes.  For patients with existing diabetes, blood glucose exceeding 11.1 mmol/L conferred higher risks of early mortality and long-term diabetes-related hospitalization.

Authors suggest that MI patient blood sugar level testing on ED admission and timely establishment of enhanced glycemic control may prevent future diabetes-related hospitalizations and other problems. This study, combined with research highlighting the timelier and precise glycemic control established through computerized vs. paper-based protocols, further highlights the value of technology for high risk populations.

New research continues to highlight the difficulties of hyperglycemia and emphasizes the importance of personalized and predictive drug dosing.