Hyperglycemia and glycemic variability are associated with the severity of sepsis in nondiabetic subjects

Purpose: The purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients. Methods: Nondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours. Sepsis severity was evaluated with the Sepsis-related Organ Failure Assessment Score (SOFA). MGL and GV in patients with SOFA >= 9 and <9 were compared. Results: Thirty nondiabetic sepsis and 10 healthy subjects were recruited. No differences were found between groups except for higher patient age in sepsis patients. The MGL and MAGE(72h) of sepsis patients were significantly higher than those of healthy subjects. MGL and GV(24h) were higher in patients with SOFA >= 9 than in patients with SOFA <9 (MGL(24h) 195 +/- 17 vs 139 +/- 27, P.001; SD24h 32 [28, 36] vs 19 [5, 58], P =.02; and MAGE(24h) 94 [ 58, 153] vs 54 [16, 179], P =.01). Conclusion: Nondiabetic sepsis patients had higher MGL and GV values than healthy subjects. MGL and GV24h were associated with sepsis severity. (C) 2016 Elsevier Inc. All rights reserved.