Assessment of Hyperglycemia in response to dietary management and severity of illness in ICU patients

Abstract

Hyperglycemia among hospitalized critically ill patients has been shown to be an independent predictor of poor outcomes. The aim was to assess the level of hyperglycemia with different dietary regimens of ICU patients (oral, and enteral feeding) and to correlate levels of blood glucose with the severity of the diseases. A prospective cohort study was conducted at ICU of King Fahad Medical City in Riyadh, Saudi Arabia, during the period between April and August 2017. Thirty-four patients from both sexes, 27 - 79 years were randomly selected. The first 24 hours’ blood glucose test was taken at the time of admission then twice/month and for a maximum of three months. The last blood glucose levels were recorded at the time when referred to the ward or at the time of discharge. The severity of illness was assessed by APACHE II score which was recorded during the first 24 hours after admission and at the time when referred to the ward or the discharge. A total of 34 subjects, 67.6% males and 32.4% females were enrolled. Their age of the subjects was 62.1±13.3 years. The mean body mass index was 27.0±5.2 kg/m2 and that of the females was significantly higher than that of the males (30.9 versus 25.1 kg/m2). The means blood glucose levels were insignificantly different between orally-fed and tube-fed patients (9.7±3.7 vs 9.5±3.2 mmol/l, respectively). Regarding the severity of the diseases, there is a positive correlation between blood glucose level and the severity of the disease assessed by APACHE II score (r=0.543, p<0.5). The mode of feeding did not affect the glycemic levels in critically ill patients and the simple blood glucose level might be used as an indicator of severity of the disease.