Izvorni znanstveni članak
https://doi.org/10.64266/amu.1.1.5
Hyperglycaemia in Critical Illness in Non-Diabetics Is Associated with Increased Intrinsic Insulin Resistance
Edita Lukić
; Medizinischen Universität Graz, Graz, Austria
Ivana Pavlić Renar
; Klinički Bolnički Centar Zagreb, Zagreb, Hrvatska
Ivan Gornik
orcid.org/0000-0001-6146-1327
; Klinički Bolnički Centar Zagreb, Zagreb, Hrvatska
*
* Dopisni autor.
Sažetak
Introduction: Hyperglycemia commonly occurs in the course of critical illness, both in patients with and without apparent glucose metabolism disorder. Insulin resistance is characterized by the reduced response of tissues to insulin. We hypothesized that one of the causes of hyperglycemia in critical illness among patients without apparent glucose metabolism disorder is intrinsically increased insulin resistance. Patients and methods: Patients with no history of impaired glucose metabolism admitted to a medical intensive care unit due to critical illness were included. They were divided into hyperglycaemia group (glucose >7.7 mmol/l, on at least two occasions) and normoglycaemia group. Glycated hemoglobin during hospital stay and oral glucose tolerance test within 6-8 weeks after discharge were performed, patients with unknown diabetes or pre-diabetes were excluded. On the follow up visit 6-8 weeks after discharge insulin resistance was assessed by indirect methods using simple indices: QUICKI, HOMA-IR, log HOMA-IR and HOMA2-IR. Results: Research was concluded on 221 patients: 114 in hyperglycaemia group and 107 in normoglycaemia group. There were no significant differences in age nor sex among groups. BMI, WHR and positive family history of type 2 diabetes had higher values in hyperglycaemia group. Patients in hyperglycaemia group had higher insulin levels (75.5 pmol/l vs 62.8 pmol/l, p<0.001) and higher insulin resistance assessed by simple insulin resistance indices compared with patients in normoglycaemia group. Multivariate logistic regression analysis showed independent association of BMI, WHR, HOMA-IR and QUICKI with occurrence of hyperglycemia in acute illness. Conclusion: Occurrence of hyperglycemia in critical illness among patients without apparent glucose metabolism disorder is associated with intrinsically increased insulin resistance.
Ključne riječi
Hyperglycaemia in Critical Illness; Insulin Resistance; Prediabetes
Hrčak ID:
333863
URI
Datum izdavanja:
1.2.2025.
Posjeta: 241 *