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Cited by 180Hyperglycemia and glycemic control in critically ill and hospitalized patientsDiabetes Management and ResearchPatient Safety and Medication Errors

The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.

Hypoglycemia, With or Without Insulin Therapy, Is Associated With Increased Mortality Among Hospitalized Patients

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Garg, Rajesh, Hurwitz, Shelley, Turchin, Alexander, Trivedi, Apoorva·2013·Diabetes Care
DOI 10.2337/dc12-1296PMC PMC3631882
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Abstract

OBJECTIVE: Hypoglycemia is associated with increased mortality in hospitalized patients. We investigated the relationship between spontaneous hypoglycemia versus insulin-associated hypoglycemia and mortality in hospitalized patients. RESEARCH DESIGN AND METHODS: Data for this retrospective cohort study were obtained from electronic databases of patients admitted between 1 April 2008 and 30 November 2010. Patients with one or more blood glucose values ≤50 mg/dL on point-of-care glucose testing were considered hypoglycemic. Patients treated with insulin were assumed to have insulin-associated hypoglycemia. Age-, sex-, and race-matched patients with all blood glucose values >70 mg/dL were selected as controls. The Charlson comorbidity index (CCI) was used to control for severity of illness. RESULTS: There were four groups: 1) noninsulin-treated hypoglycemia (NTH) (n = 135), 2) insulin-treated hypoglycemia (ITH) (n = 961), 3) noninsulin-treated control (NTC) (n = 1,058), and 4) insulin-treated control (ITC) (n = 736). Mortality was higher in the ITH group compared with the ITC group (20.3 vs. 4.5%, P < 0.0001), with a relatively higher CCI (1.8 vs. 1.5%, P < 0.0001), but much higher in the NTH group compared with the NTC group (34.5 vs. 1.1%, P < 0.0001), with much higher CCI (2.4 vs. 1.1%, P < 0.0001). Mortality was higher in the NTH group compared with the ITH group (P < 0.0001) but lower in the NTC group compared with the ITC group (P < 0.0001). After controlling for age, sex, CCI, and admission to the intensive care unit, insulin treatment was associated with a lower mortality among the hypoglycemic patients; hazard ratio of death in the ITH group relative to the NTH group was 0.34 (95% CI 0.25-0.47, P < 0.0001). CONCLUSIONS: Insulin-associated and spontaneous hypoglycemia are associated with increased mortality among hospitalized patients.

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Metadata

Authors
Garg, R., Hurwitz, S., Turchin, A., & Trivedi, A.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Garg, Rajesh
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2013-04-13
Volume
36
Issue
5
Pages
1107-1110
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc12-1296
PMC
PMC3631882
OpenAlex
W2130532045
Cited by
176
References
17
Citations by year
2026: 5 · 2025: 10 · 2024: 9 · 2023: 12 · 2022: 14 · 2021: 12 · 2020: 19 · 2019: 11 · 2018: 14 · 2017: 13 · 2016: 19 · 2015: 17 · 2014: 12 · 2013: 9
FWCI
9.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
National Center for Research Resources (UL1RR025758)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Keywords
insulin therapy, mortality, hospitalized patients, spontaneous hypoglycemia, blood glucose, intensive care unit admission, comorbidities, point-of-care glucose testing, critically ill patients, diabetes management, glycemic control, mortality risk factors, mortality risk stratification
MeSH terms
Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Retrospective Studies, Hospital Mortality

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