Glycemic control in non-critically ill hospitalized patients: A systematic review and meta-analysis

Mohammad H Murad, John A. Coburn, Fernando Coto-Yglesias, Svitlana Dzyubak, Ahmad Hazem, Melanie A. Lane, Larry J. Prokop, Victor Manuel Montori

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Background: The effect of intensive therapy to achieve tight glycemic control in patients hospitalized in non-critical care settings is unclear. Methods:Weconducted a systematic review and meta-analysis to determine the effect of intensive glycemic control strategies on the outcomes of death, stroke, myocardial infarction, incidence of infection, and hypoglycemia. We included randomized and observational studies. Bibliographic databases were searched through February 2010. Random effects model was used to pool results across studies. Results: Nineteen studies (nine randomized and 10 observational studies) were included. The risk of bias across studies was moderate. Meta-analysis demonstrates that intensive glycemic control was not associated with significant effect on the risk of death, myocardial infarction, or stroke. There was a trend for increased risk of hypoglycemia (relative risk, 1.58; 95% confidence interval,0.97-2.57), particularly in surgical studies and when the planned glycemic target was achieved. Intensive glycemic control was associated with decreased risk of infection (relative risk, 0.41; 95% confidence interval, 0.21-0.77) that was mainly derived from studies in surgical settings. Conclusion: Intensive control of hyperglycemia in patients hospitalized in non-critical care settings may reduce the risk of infection. The quality of evidence is low and mainly driven by studies in surgical settings.

Original languageEnglish (US)
Pages (from-to)49-58
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number1
DOIs
StatePublished - Jan 2012

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Meta-Analysis
Hypoglycemia
Observational Studies
Infection
Stroke
Myocardial Infarction
Bibliographic Databases
Confidence Intervals
Hyperglycemia
Incidence

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Glycemic control in non-critically ill hospitalized patients : A systematic review and meta-analysis. / Murad, Mohammad H; Coburn, John A.; Coto-Yglesias, Fernando; Dzyubak, Svitlana; Hazem, Ahmad; Lane, Melanie A.; Prokop, Larry J.; Montori, Victor Manuel.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 1, 01.2012, p. 49-58.

Research output: Contribution to journalArticle

Murad, Mohammad H ; Coburn, John A. ; Coto-Yglesias, Fernando ; Dzyubak, Svitlana ; Hazem, Ahmad ; Lane, Melanie A. ; Prokop, Larry J. ; Montori, Victor Manuel. / Glycemic control in non-critically ill hospitalized patients : A systematic review and meta-analysis. In: Journal of Clinical Endocrinology and Metabolism. 2012 ; Vol. 97, No. 1. pp. 49-58.
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