2nd journal readingEmal SuhediHyperglycemia in sepsis isa risk factor for development of type II diabetesno diabetesno diabetesHyperglycemiaacut infection sepsis

no impaired glucosemetabolismno impaired glucosemetabolismconsequence of inflammatory response and stressthe existence of latent disturbance of glucose metabolism that contributes to the development of hyperglycemia and the patients might have increased risk for diabetesthe existence of latent disturbance of glucose metabolism that contributes to the development of hyperglycemia and the patients might have increased risk for diabetesTo observe Hyperglycaemia at Sepsis as the risk factor for development of DM T2 Patientsdult Sepsis The Medical !ntensive "are #nit $!"#%& #niversity Hospital 'ebro ( years $July 1998-June 2003%)egativeHistory for Diabetes Mellitus $DM%&

!mpaired fasting glucose $!*+% or !mpaired glucose tolerance $!+T% methodsprospective& noninterventional single,center study------ The follo-ing data -ere collected for all patients. Age,Sex,Family History of Diabetes, Body Mass Index (BMI), Serum Colesterol and !rigly"eride "on"entrations# dmission cute /hysiology and "hronic Health 0valuation $/"H0 !!% score Sequential 1rgan ssessment Score $S1*% score 2lood glucose $venous%2times a day. at 3 M $fasting% and 3 /M $2 hours postprandial%4 5enous blood -as analy6ed on point,of,care analy6er (I$ %&M 'remier ()))* Instrumentation $aboratory, $exington, M+, ,S+)#exclusion criteriaexclusion criteria !*+& !+T& or DM $ 7 % "orticosteroid treatment during the !"# admission or 2 months before the !"# admission 0ndocrine disorder that may alter glucose metabolism Disseminated malignant disease or any other acute or chronic condition /atients -ho -ere un-illing to participate /atients -ith only 8 hyperglycemic value !*+& !+T& or DM $ 7 % "orticosteroid treatment during the !"# admission or 2 months before the !"# admission 0ndocrine disorder that may alter glucose metabolism Disseminated malignant disease or any other acute or chronic condition /atients -ho -ere un-illing to participate /atients -ith only 8 hyperglycemic valuedult patients -ith sepsis admitted to the medical intensive care unit $!"#%no history of impaired glucose metabolism $ IFG, IGT, or DM %dult patients -ith sepsis admitted to the medical intensive care unit $!"#%no history of impaired glucose metabolism $ IFG, IGT, or DM %inclusion criteriainclusion criteriaIGTIGTIFGIFGDMDMDcriteriaDcriteria Med"alc v4 942484: statistical soft-are -as used for all statistical analyses patients -ith hyperglycemia during sepsis are at increased risk ofdeveloping type 2 diabetes mellitus or impaired glucose metabolism $!*+ or !+T% The results also confirm previously kno-n fact that hyperglycemia is more frequent in more severe disease and that it is associated -ith higher mortality risk /atients -ith hyperglycemia did have higher 2M! and higher triglycerideconcentrations& -hich maybe a reflection of their greater susceptibility to hyperglycemiasevere sepsissevere sepsisseptic shockseptic shockSepsisSepsisthe usual criteria More severely ill have more chance of developing hyperglycemia even -ith normal metabolism& and therefore have smaller risk of developing diabetes in the follo-,up period Substantiates hypothesis that there is some other factor contributing to hyperglycemia other than severity of disease 'esearcher . hyperglycemia during critical illness as venous blood glucose concentration )949 mmol;< $8=: mg;d/0'+"0M!ST'0SS H>/0'+"0M!hypothalamic,pituitary,adrenal axishypothalamic,pituitary,adrenal axis)T!,!)S#uid balance 4520 !?;@g over 2A hrs71 3 8yperglyce!ia 4plas!a glucose 5120 !g;d? or B.B !!ol;?7 in the absence o" diabetes1 1 In>a!!atory variables1 3 ?eu@ocytosis 4C, count 512D000 ;!!371 3 ?eu@openia 4C, count 9A000 ;!!371 3 )or!al C, count %ith 510E i!!ature "or!s1 3 Flas!a ,-reactive protein 52