Background

Critical illness is still a major part of burden on healthcare systems and comprises about 7.6% of total in-hospital admissions¹. Critically ill patients have different glucose metabolism due to stress related conditions, an entity labeled as stress hyperglycemia which is mainly attributed to release of counter regulatory hormones^2,3. Stress hyperglycemia is found in both diabetic as well as non-diabetics moreover in non- diabetics⁴. Fasting blood sugar, postprandial blood sugar, HbA1c are important predictors of glycemic control. But these have limitations in critical set up and thus there is one more entity beyond these traditional markers i. e. glycemic variability (GV)³ which may be an important predictor of outcome in critically ill patients.

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11. Zhang J-W, He L-J, Cao S-J, et al. Effect of glycemic variability on short term prognosis in acute myocardial infarction subjects undergoing primary percutaneous coronary interventions. Diabetol Metab Syndr. 2014; 6(1):76.
12. Su G, Mi S, Tao H, Li Z, et al. Impact of admission glycemic variability, glucose, and glycosylated hemoglobin on major adverse cardiac events after acute myocardial infarction. Diabetes Care. 2013; 36(4):1026–32.
13. Krinsley JS. Glycemic variability: a strong independent predictor of mortality in critically ill patients. Crit Care Med 2008; 36:3008–13.
14. Ali NA, O’Brien JM Jr, Dungan K, et al. Glucose variability and mortality in patients with sepsis. Crit Care Med. 2008; 36(8): 2316–21.

Dr Rajashree Khot

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