Stress hyperglycaemia

Dungan, Kathleen; Braithwaite, Susan S.; Preiser, Jean‐Charles

doi:10.1016/s0140-6736(09)60553-5

Cited by 1,101 publications

(1,121 citation statements)

References 119 publications

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“…Although the mechanism seems to be well known, the impact on DM development remains scarce 44, 48, 49. Furthermore, the impact on long‐term mortality among patients with stable CAD is unknown.…”

Section: Discussionmentioning

confidence: 99%

Impaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease

Younis

Goldkorn

Goldenberg

et al. 2017

JAHA

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BackgroundWe wanted to explore the association of metabolic syndrome (MetS) versus its individual components with 20‐year all‐cause mortality among patients with stable coronary artery disease.Methods and ResultsThe cohort comprised 12 403 nondiabetic patients with stable coronary artery disease who were enrolled in the Bezafibrate Infarction Prevention Registry between February 1990 and October 1992 and followed up through December 2014. The study cohort was divided into 4 groups: patients without MetS or impaired fasting glucose (IFG), patients with IFG but without MetS, patients with MetS but without IFG, and patients with both MetS and IFG. Kaplan‐Meier survival analysis showed that at 20 years of follow‐up, the rates of all‐cause mortality were the highest among patients with both MetS and IFG (66%). Patients with IFG without MetS experienced a significantly higher mortality rate compared with those with MetS without IFG (61% versus 56%; log‐rank P<0.001). Multivariable Cox proportional hazard analysis showed that the final Cox model demonstrated that the additive effect of MetS (hazard ratio, 1.13; 95% confidence interval, 1.1–1.16; P=0.02) and IFG (hazard ratio, 1.54; 95% confidence interval, 1.46–1.62; P<0.001) on 20 years mortality was nonsignificant (hazard ratio, 1.01; 95% confidence interval, 0.93–1.11; P=0.69). IFG was associated with the most pronounced increase in mortality risk among the individual components (hazard ratio, 1.22; 95% confidence interval, 1.14–1.3; P<0.001).ConclusionsOur findings suggest that IFG alone is a major independent predictor of long‐term mortality among patients with stable coronary artery disease versus other components of the MetS.

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Section: Discussionmentioning

confidence: 99%

Impaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease

Younis

Goldkorn

Goldenberg

et al. 2017

JAHA

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“…12 Virtually every inpatient has at least 1 glucose value drawn during hospitalization as part of a chemistry panel, many of which are fasting, or ''NPO'' (''nil per os'', meaning nothing by mouth), by virtue of clinical condition or anticipated procedure. Provided the preoperative state in an elective surgery patient is not taxing enough to induce stress hyperglycemia, [13][14][15] this typically fasting time may provide an easy and excellent diabetes screening opportunity to not only risk stratify for the inpatient stay, but to diagnose diabetes that will initiate lifelong care and prevention, provided information learned during hospitalization is conveyed to the PCP at discharge. While prior studies [16][17][18] have measured preoperative glucose as a means to risk stratify and predict undiagnosed diabetes, none of these analyses have obtained a second glycemic test (either FBG or Hgb A 1C ) as required by the American Diabetes Association (ADA) to make a diagnosis of diabetes.…”

Section: Objectivementioning

confidence: 99%

Preoperative “NPO” as an opportunity for diabetes screening

Sheehy¹,

Benca

Glinberg

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:Novel preventive care opportunities, such as in hospitalized patients, may merit further investigation in an Accountable Care Organization (ACO) model. As 40% of patients with diabetes are undiagnosed, diabetes screening is an urgent public health need. Screening fasting preoperative patients may present an effective means to identify patients who might otherwise remain undiagnosed.OBJECTIVE:To pilot an inpatient preventive care strategy for diabetes screening that would ascertain prevalence of unrecognized inpatient diabetes (DM) and impaired fasting glucose (IFG), determine reproducibility of preoperative fasting blood glucose (FBG), and establish feasibility of inpatient preventive screening.DESIGN:Prospective observational study.SETTING:Large Midwestern academic medical center.PATIENTS:Two hundred seventy‐five elective orthopedic patients with a preoperative visit between December 1, 2007 and November 30, 2008. Most patients (96.6%) had seen their primary care provider (PCP) within 12 months, and 100% were insured.MEASUREMENTS:Medical history was recorded, and hemoglobin A1C (Hgb A1C) and FBG were drawn immediately prior to surgery. Patients with preoperative FBG ≥100 mg/dL had FBG drawn 6–8 weeks postoperatively.RESULTS:Twenty‐four percent (67/275) of patients had previously unrecognized DM or IFG by virtue of 2 abnormal values. Sixty‐four percent of patients with FBG ≥100 mg/dL preoperatively remained elevated at ambulatory follow‐up. No patients with new DM or IFG had point‐of‐care glucose checks ordered or had dysglycemia mentioned on discharge summary.CONCLUSIONS:Inpatient undiagnosed DM and IFG is common, even in insured, elective surgery patients with recent primary care visits. Preoperative FBG can be used to screen, but results need to be conveyed to PCPs. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

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“…Adanya faktor-faktor risiko yang lain memperberat terjadinya proses atherosklerosis. 3,11,[12][13][14] Proporsi pasien yang mengalami stroke, penyakit ginjal kronik dan infeksi dijumpai dalam jumlah kecil, baik pada kelompok BPK, IKP maupun medikamentosa. Dibandingkan kelompok IKP dan medikamentosa, proporsi stroke pada kelompok BPK paling besar (16.1%).…”

Section: Karakteristikunclassified

Kesintasan Lima Tahun Pasien Penyakit Jantung Koroner Tiga Pembuluh Darah dengan Diabetes Melitus yang Menjalani Bedah Pintas Koroner, Intervensi Koroner Perkutan atau Medikamentosa di Rumah Sakit dr. Cipto Mangunkusumo

Setiawan¹,

Panggabean²,

Yamin³

et al. 2017

JPDI

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ABSTRAKPendahuluan. Hasil revaskularisasi pada pasien diabetes melitus (DM) dengan penyakit jantung koroner 3 pembuluh darah (PJK 3PD) dengan bedah pintas koroner (BPK) lebih baik dibandingkan intervensi koroner perkutan (IKP) atau medikamentosa. BPK tidak selalu menjadi prosedur yang dikerjakan meskipun sudah direkomendasikan sesuai Skor Syntax. Selain itu, tidak semua pasien bersedia menjalani BPK atau IKP. Perlu diketahui apakah pilihan revaskularisasi tersebut mempengaruhi kesintasan 5 tahun.Metode. Penelitian ini merupakan studi kohort retrospektif dengan pendekatan analisis kesintasan untuk meneliti kesintasan 5 tahun pasien PJK 3PD DM yang menjalani tindakan BPK, IKP atau medikamentosa. Penelitian dilakukan dengan menggunakan data sekunder 126 pasien PJK 3PD DM yang menjalani BPK, IKP, maupun medikamentosa di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada tahun 2006-2007 dan diikuti sampai dengan tahun 2011-2012 dengan dilihat adakah kejadian meninggal.Hasil. Kesintasan terbaik diketahui yaitu pada kelompok BPK (93,5%). Proporsi kematian terbesar terdapat pada kelompok medikamentosa (36,1%). Selain itu, hasil analisis menunjukkan bahwa kelompok IKP memiliki kesintasan yang lebih baik dibanding medikamentosa (69,5% vs 63,9%). Meskipun tidak bermakna secara statistik, namun pada kelompok IKP proporsi keluhan yang ditemukan setelah tindakan lebih sedikit dibanding kelompok medikamentosa (52% vs 38%). Skor Syntax yang berperan menilai kompleksitas stenosis diketahui turut menentukan kesintasan (p= 0,039).Simpulan. Kesintasan 5 tahun pasien PJK 3PD dengan DM yang paling baik didapatkan pada kelompok yang menjalani BPK. Kesintasan 5 tahun pasien PJK 3PD dengan DM yang menjalani IKP lebih baik dibandingkan medikamentosa, namun secara statistik tidak bermakna. Faktor yang berpengaruh pada kesintasan 5 tahun pasien PJK 3PD adalah kompleksitas stenosis yang dilihat dengan menggunakan skor Syntax. Kata kunci: DM, kesintasan 5 tahun, PJK 3PD

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Stress hyperglycaemia

Cited by 1,101 publications

References 119 publications

Impaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease

Impaired Fasting Glucose Is the Major Determinant of the 20‐Year Mortality Risk Associated With Metabolic Syndrome in Nondiabetic Patients With Stable Coronary Artery Disease

Preoperative “NPO” as an opportunity for diabetes screening

Kesintasan Lima Tahun Pasien Penyakit Jantung Koroner Tiga Pembuluh Darah dengan Diabetes Melitus yang Menjalani Bedah Pintas Koroner, Intervensi Koroner Perkutan atau Medikamentosa di Rumah Sakit dr. Cipto Mangunkusumo

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