Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units
<p>Estimated marginal means of the number of hypoglycemic events according to DM status and significant change in creatinine (SCIC) status.</p> "> Figure 2
<p>Rate of hypoglycemia incidence across quintiles of creatinine change among patients with significant change in creatinine (SCIC).</p> "> Figure 3
<p>Percent of patients with hypoglycemia according to timing of first hypoglycemic event from significant change in creatinine (SCIC) diagnosis, among patients with (right panels) and without DM (left panels).</p> "> Figure 4
<p>Cumulative survival of patients across time to hypoglycemia and significant change in creatinine (SCIC).</p> ">
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Association between SCIC Status and Hypoglycemia
3.2. Association between Hypoglycemia and SCIC Magnitude
3.3. Ascertaining Timing of SCIC and Hypoglycemia
3.4. Association between Age, Incident Hypoglycemia and SCIC
3.5. “Deteriorating” SCIC vs. “Improving” SCIC
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | SCIC n = 5639 | no SCIC n = 19,761 | p Value |
---|---|---|---|
Male sex (%) | 52.4 | 48.4 | p < 0.001 |
Age (years) | 76.1 ± 15.7 | 68.2 ± 18.3 | p < 0.001 |
Acute conditions in discharge letter | |||
Exacerbation of CHF (%) | 9.7 | 4.9 | p < 0.001 |
Exacerbation of COPD (%) | 4.6 | 3.2 | p < 0.001 |
Acute coronary syndrome (%) | 3.4 | 1.9 | p < 0.001 |
Acute infection (any site) (%) | 40.1 | 19.8 | p < 0.001 |
Co-morbidities | |||
CHF (%) | 16.0 | 8.5 | p < 0.001 |
COPD (%) | 13.3 | 10.5 | p < 0.001 |
CVA (%) | 9.5 | 7.1 | p < 0.001 |
Dementia (%) | 8.2 | 3.9 | p < 0.001 |
Hypertension (%) | 57.8 | 50.4 | p < 0.001 |
IHD (%) | 22.0 | 18.8 | p < 0.001 |
Hyperlipidemia (%) | 36.0 | 35.4 | 0.384 |
Liver disease (%) | 4.2 | 3.6 | 0.029 |
Malignancy-all types all stages | 8.5 | 6.0 | p < 0.001 |
PVD (%) | 4.0 | 2.5 | p < 0.001 |
Hypothyroidism (%) | 8.4 | 7.5 | p = 0.029 |
Diabetes mellitus (%) | 39.9 | 30.0 | p < 0.001 |
Admission measurements and laboratory data | |||
Temperature (°C) | 36.8 ± 0.6 | 36.8 ± 0.4 | p < 0.001 |
Heart rate (BPM) | 84.7 ± 18.8 | 79.8 ± 17.4 | p < 0.001 |
Systolic blood pressure (mmHg) | 135 ± 28 | 141 ± 26 | p < 0.001 |
Diastolic blood pressure (mmHg) | 73 ± 14 | 78 ± 13 | p < 0.001 |
White blood cell count (cells per mm3 × 103) | 12.7 ± 2.0 | 10.0 ± 6.4 | p < 0.001 |
Hemoglobin (g/dL) | 12.2 ± 2.3 | 12.8 ± 2.0 | p < 0.001 |
Sodium (meq/L) | 137 ± 6 | 137 ± 5 | p < 0.001 |
Potassium (meq/L) | 4.3 ± 0.7 | 4.1 ± 0.5 | p < 0.001 |
Cholesterol (mg/dL) | 147 ± 47 | 165 ± 45 | p < 0.001 |
Serum albumin (g/dL) | 3.4 ± 0.6 | 3.9 ± 0.5 | p < 0.001 |
C-Reactive Protein (mg/dL) | 9.5 ± 10.6 | 4.1 ± 6.6 | p < 0.001 |
Mean glucose during hospitalization (mg/dL) | 150 ± 54 | 133 ± 46 | p < 0.001 |
Incident hypoglycemia (%) | 13.1 | 4.1 | p < 0.001 |
Deteriorating SCIC n = 2129 | Improving SCIC n = 3510 | p Value | |
---|---|---|---|
Age (years) | 78.7 ± 0.3 | 74.5 ± 16.6 | <0.001 |
Male sex (%) | 49.4 | 54.2 | <0.001 |
Length of stay (days) | 14.5 ± 0.8 | 8.8 ± 9.3 | <0.001 |
Admission measurements and laboratory data | |||
Temperature (°C) | 36.8 ± 0 | 36.9 ± 0.5 | <0.001 |
Heart rate (BPM) | 86.2 ± 0.4 | 83.8 ± 18.3 | <0.001 |
Systolic blood pressure (mmHg) | 137.3 ± 0.7 | 133 ± 26.4 | <0.001 |
Diastolic blood pressure (mmHg) | 73.6 ± 0.4 | 72.4 ± 13.4 | 0.005 |
White blood cell count (cells per cmm × 103) | 12.4 ± 0.2 | 12.9 ± 10.1 | 0.041 |
Hemoglobin (g/dL) | 11.8 ± 0 | 12.4 ± 2.3 | <0.001 |
Cholesterol (mg/dL) | 148.2 ± 1.1 | 146.4 ± 46.3 | 0.170 |
Serum albumin (g/dL) | 3.4 ± 0 | 3.5 ± 0.6 | <0.001 |
C-Reactive Protein (mg/dL) | 9.2 ± 0.2 | 9.8 ± 10.8 | 0.048 |
Admission creatinine (mg/dL) | 1.39 ± 0.65 | 1.55 ± 0.59 | <0.001 |
Co-morbidities | |||
Acute infection (any site) (%) | 41.2 | 39.4 | 0.183 |
CHF (%) | 25.0 | 10.6 | <0.001 |
Hypertension (%) | 62.4 | 55.0 | <0.001 |
Diabetes mellitus (%) | 41.7 | 38.9 | 0.037 |
Incident Hypoglycemia (%) | 16.9 | 10.7 | <0.001 |
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Zingerman, B.; Khanimov, I.; Shimonov, M.; Boaz, M.; Rozen-Zvi, B.; Leibovitz, E. Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units. J. Clin. Med. 2022, 11, 6852. https://doi.org/10.3390/jcm11226852
Zingerman B, Khanimov I, Shimonov M, Boaz M, Rozen-Zvi B, Leibovitz E. Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units. Journal of Clinical Medicine. 2022; 11(22):6852. https://doi.org/10.3390/jcm11226852
Chicago/Turabian StyleZingerman, Boris, Israel Khanimov, Mordechai Shimonov, Mona Boaz, Benaya Rozen-Zvi, and Eyal Leibovitz. 2022. "Changes in Serum Creatinine May Cause Hypoglycemia among Non-Critically Ill Patients Admitted to Internal Medicine Units" Journal of Clinical Medicine 11, no. 22: 6852. https://doi.org/10.3390/jcm11226852