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Prevalence and Prognostic Significance of Dysglicemia in Patients With Type 2 Diabetes Mellitus at the Stage of Decompensation of Chronic Cardiac Failure

Year: 2019

Type: article

Abstract: The aim was to study the prevalence of dysglycemia and glycemic variability (GV) during hospitalization for chronic heart failure (CHF) decompensation and their effect on four-years survival. Methods: A retrospective analysis of the hospital records of 279 patients with type 2 diabetes mellitus (DM), hospitalized with CHF decompensation to the First City Clinical Hospital in Arkhangelsk was performed. Mann - Whitney tests were used for numeric variables. Simple and multiple logistic regression analyses were used to determine the effect of glycemia at admission, GV indicators on the early and long-term prognosis. Results: Median blood glucose at hospitalization was 8.80 (6.74; 11.04) mmol/l. Off-target glycemia was observed in 245 (87.8 %) patients. More than half of the measured tests during hospitalization had glycemic values beyond the recommended levels for the hospitalization period (82.6 %). In patients who died in the long-term period (n = 64, 28.1 %), hyperglycemia of more than 10.0 mmol/l was observed in 43.8 % of the measured tests during hospitalization, in 18.3 % - hyperglycemia from 7.8 to 10.0 mmol/l. Patients who died in the long-term period had higher indices of GV in comparison with the survivors (p = 0.004 for glycemic level variation, p = 0.008 for standard deviation and p = 0.001 for variation coefficient). High GV was associated (OR: 1.943; CI 1.013-3.725, p = 0.046) with the outcome, regardless of gender, manifestations of heart failure and renal function. Conclusions. Altogether, 87.8 % of patients had dysglycemia during the period of hospitalization. High GV during hospitalization was observed in 50.2 % of patients. High GV during hospitalization is an independent risk factor for for-years mortality

Source: Экология человека

DOI: 10.33396/1728-0869-2019-11-48-54

Authors: M. Yu. Ishekova, I. V. Dvoryashina, K. K. Kholmatova, A. M. Grjibovski

Institutions: Northern State Medical University, UiT The Arctic University of Norway, North-Eastern Federal University, Al-Farabi Kazakh National University, West Kazakhstan Marat Ospanov State Medical University

Language: English

Topic: Hyperglycemia and glycemic control in critically ill and hospitalized patients

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W2988033460

FWCI:

Cites: 16

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Related to: 10