Hyperglycaemia in critical illness is a risk factor for later development of type II diabetes mellitus.

ABSTRACT

Hyperglycaemia caused by stress and inflammation is common during critical illness. We hypothesised that a latent glucose metabolism disturbance contributes to development of hyperglycaemia and that those patients have increased risk for diabetes. We included patients with sepsis, acute coronary syndrome and acute heart failure with no history of impaired glucose metabolism and divided them in the hyperglycaemia group (glucose ≥ 7.8 mmol/l) and normoglycaemia group. Patients were followed for 5 years. Follow-up was completed for 115 patients in the normoglycaemia group, of which 4 (3.5%) developed type 2 diabetes. In the hyperglycaemia group 51 patients finished follow-up and 8 (15.7%) developed type 2 diabetes. Relative risk in 5-year period for patients with hyperglycaemia was 4.51 for development of type 2 diabetes. Patients with hyperglycaemia during critical illness who are not diagnosed with diabetes before or during the hospitalisation should be considered a population at increased risk for developing diabetes.