Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization |
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Authors: | Jothydev Kesavadev Anoop Misra Banshi Saboo S.R. Aravind Akhtar Hussain Leszek Czupryniak Itamar Raz |
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Affiliation: | 1. Jothydev’s Diabetes Research Centers, Kerala, India;2. Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, India;3. National Diabetes, Obesity and Cholesterol Foundation (N-DOC), India;4. Diabetes Foundation (India) (DFI), India;5. Diacare, Diabetes Care & Hormone Clinic, Ahmedabad, India;6. Diacon Hospital, Bangalore, India;7. Faculty of Health Sciences, Chronic Disease-Diabetes, NORD University, Stjørdal, Norway;8. Faculty of Medicine, Federal University of Ceara, Brazil;9. Medical University of Warsaw, Department of Diabetology and Internal Medicine, Warsaw, Poland;10. Internal Medicine, and Head of the Diabetes Unit at Hadassah University Hospital, Israel |
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Abstract: | Background and aimsThe measurement of vital signs is an important part of clinical work up. Presently, measurement of blood glucose is a factor for concern mostly when treating individuals with diabetes. Significance of blood glucose measurement in prognosis of non-diabetic and hospitalized patients is not clear.MethodsA systematic search of literature published in the Electronic databases, PubMed and Google Scholar was performed using following keywords; blood glucose, hospital admissions, critical illness, hospitalizations, cardiovascular disease (CVD), morbidity, and mortality. This literature search was largely restricted to non-diabetic individuals.ResultsBlood glucose level, even when in high normal range, or in slightly high range, is an important determinant of morbidity and mortality, especially in hospitalized patients. Further, even slight elevation of blood glucose may increase mortality in patients with COVID-19. Finally, blood glucose variability and hypoglycemia in critically ill individuals without diabetes causes excess in-hospital complications and mortality.ConclusionIn view of these data, we emphasize the significance of blood glucose measurement in all patients admitted to the hospital regardless of presence of diabetes. We propose that blood glucose be included as the “fifth vital sign” for any hospitalized patient. |
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Keywords: | Blood glucose Cardiovascular disease Impaired glucose tolerance Intensive insulin therapy Hypoglycemia Glycemic variability |
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