TY - JOUR
T1 - Characteristics and Outcomes of Patients With and Without Type 2 Diabetes Mellitus and Pulmonary Sepsis
AU - Sathananthan, Matheni
AU - Sathananthan, Airani
AU - Jeganathan, Niranjan
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Purpose: To date, studies have provided conflicting results regarding the impact of type 2 diabetes mellitus (DM) on sepsis-related outcomes. Our objective is to understand the impact of type 2 DM in bacterial pneumonia and sepsis-related intensive care unit (ICU) outcomes. Methods: Retrospective study using Multiparameter Intelligent Monitoring in Intensive Care III database. We included 1698 unique patients admitted with sepsis secondary to bacterial pneumonia to the ICU within the time period of 2001 to 2012. Results: The type 2 DM group had an increased incidence of acute kidney injury (67.9% vs 58.1%, P <.01) and need for dialysis compared to the non-DM group. There was no difference in mortality, microbiology, other organ failure, or hospital length of stay between the type 2 DM and non-DM group. Lower admission blood glucose was associated with increased mortality in patients with type 2 DM (49% at ≤120 mg/dL, 35.1% at 121-180 mg/dL, and 32.1% at >180 mg/dL) but not in non-DM patients. Conversely, higher mean glucose during the hospital stay was associated with increased mortality in non-DM patients (24.7% at ≤120 mg/dL, 45.1% at 121-180 mg/dL, and 73.0% at >180 mg/dL) but not in patients with type 2 DM. Conclusions: Our findings demonstrated that type 2 DM does not increase the overall mortality. Our findings of increased mortality in both type 2 DM patients with lower admission glucose, and non-DM patients with higher mean glucose during the hospital stay needs to be further evaluated. Future studies in regards to this could lead to personalized glucose treatment goals for patients.
AB - Purpose: To date, studies have provided conflicting results regarding the impact of type 2 diabetes mellitus (DM) on sepsis-related outcomes. Our objective is to understand the impact of type 2 DM in bacterial pneumonia and sepsis-related intensive care unit (ICU) outcomes. Methods: Retrospective study using Multiparameter Intelligent Monitoring in Intensive Care III database. We included 1698 unique patients admitted with sepsis secondary to bacterial pneumonia to the ICU within the time period of 2001 to 2012. Results: The type 2 DM group had an increased incidence of acute kidney injury (67.9% vs 58.1%, P <.01) and need for dialysis compared to the non-DM group. There was no difference in mortality, microbiology, other organ failure, or hospital length of stay between the type 2 DM and non-DM group. Lower admission blood glucose was associated with increased mortality in patients with type 2 DM (49% at ≤120 mg/dL, 35.1% at 121-180 mg/dL, and 32.1% at >180 mg/dL) but not in non-DM patients. Conversely, higher mean glucose during the hospital stay was associated with increased mortality in non-DM patients (24.7% at ≤120 mg/dL, 45.1% at 121-180 mg/dL, and 73.0% at >180 mg/dL) but not in patients with type 2 DM. Conclusions: Our findings demonstrated that type 2 DM does not increase the overall mortality. Our findings of increased mortality in both type 2 DM patients with lower admission glucose, and non-DM patients with higher mean glucose during the hospital stay needs to be further evaluated. Future studies in regards to this could lead to personalized glucose treatment goals for patients.
KW - bacterial pneumonia
KW - blood glucose
KW - mortality
KW - organ dysfunction
KW - sepsis
KW - severe sepsis
KW - type 2 diabetes mellitus
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U2 - 10.1177/0885066619833910
DO - 10.1177/0885066619833910
M3 - Article
C2 - 30841774
SN - 0885-0666
VL - 35
SP - 836
EP - 843
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 9
ER -