Effect of diabetes on various outcomes in intensive care settings: A case–control study

Abstract

Abstract: BACKGROUND: There are conflicting data in the literature about the influence of diabetes on clinical outcomes and death in critically ill patients. Thus, we assessed the effect of diabetes on mortality rate and other outcomes in critically ill patients admitted to the intensive care unit (ICU). MATERIALS AND METHODS: This prospective case–control was conducted in the ICU of a tertiary care institute. Adult critically ill diabetics (cases, n = 46) and nondiabetic patients (controls, n = 85) were included in this study. Both the groups were compared regarding mortality rate, length of ICU stay, as well as the need for mechanical ventilation (MV) and inotropic/vasopressor supports. RESULTS: The groups did not differ significantly regarding age (P = 0.087), sex (P = 0.568), and vital parameters (P > 0.05). The groups were comparable regarding Glasgow Coma Scale (P = 0.882), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P = 0.774), and laboratory parameters (P > 0.05), except significantly greater proportion of diabetic patients had plasma glucose >200 mg/dL (P < 0.0001) and serum HCO3 <18 mEq/L (P = 0.038) relative to nondiabetic patients. The groups did not differ significantly in need of MV (P = 0.413), or vasopressor support (P = 0.590), development of AKI (P = 0.424), and length of ICU stay of 0–3 days (P = 0.300). Around a quarter of diabetic (26.09%) and nondiabetic patients (23.53%) were nonsurvivors (P = 0.745). Assessment of mortality according to the age groups, indication of admission, plasma glucose levels, and APACHE II score suggested no significant difference between the groups (all P > 0.05). CONCLUSION: In critically ill patients, the presence of diabetes does not affect outcomes, including the need for MV or vasopressor support, development of AKI, length of ICU stay, and mortality.