糖尿病未必增加重症监护病房患者的死亡率

近年来一些研究结果显示在发生急性高血糖的重症监护病房(ICU)患者中,糖尿病患者的死亡率低于非糖尿病患者,而且无糖尿病史的患者更能从强化胰岛素治疗中获益.这似提示糖尿病对危重疾病潜在的"保护"作用.可能的"保护"机制包括糖尿病对慢性氧化应激状态的适应性反应、糖尿病患者危重疾病并发症的发生率下降及一些非生物学保护因素.因此对于无糖尿病史高血糖ICU患者的血糖管理应当给予更多的关注.

Diabetes mellitus may not increase mortality of patients in intensive care units

In recent years,several studies have revealed that diabetic patients may have decreased mortality compared with non-diabetic patients from acute hyperglycemia in intensive care units (ICUs),and the patients without diabetic history are most likely to benefit from intensive insulin therapy.This probably suggests a potential "protective" effect in diabetic patients with critical illness.Possible "protective" mechanisms include the adaptive reaction to chronic oxidative stress state in diabetes,the decreased incidence of acute complications followed by critical illness,and some non-biological factors.Thus much more attention of glycemic management should be paid to those hyperglyemic patients without diabetic history in ICUs.