Glycaemic Alterations in ICU

NCT ID: NCT02516358

Last Updated: 2015-09-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-09-30

Study Completion Date

2016-09-30

Brief Summary

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To quantify the local prevalence of diabetes mellitus in critically ill patients. To understand whether a correlation does exist between premorbid glycaemic control and glycaemic status in ICU. A subgroup analysis will be conducted to investigate whether a relationship does exist between Neuron Specific Enolase levels and glycaemic disorders.

Detailed Description

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The aim of this study is to determine the local prevalence of critical illness-associated hyperglycaemia (CIAH) and recognised and unrecognised diabetes, as well as to evaluate how premorbid glycaemia impacts the relationship between three glycaemic domains and mortality.

The investigators will calculate the Time In Range (TIR, 70-180 mg/dl) and evaluate distribution of percentage time in range for non-diabetics and diabetics patients, in order to understand the association between TIR and survival in both groups of patients (patients with diabetes and patients without diabetes).

In view of the potential adverse effects of hyperglycaemia, hypoglycaemia and glycaemic variability on the brain, the investigators will dose Neuron Specific Enolase in critically ill patients.

The aim is to define if a biochemical correlation does exist between critically ill dysglycaemia and NSE plasma concentration.

Conditions

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Diabetes Mellitus

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* ICU patients
* expected ICU length of stay \> 48 hours

Exclusion Criteria

* age \<18 years
* ICU length of stay \<48 hours
* diabetic ketoacidosis
* hyperosmolar nonketonic hyperglycaemia syndrome
* pregnancy
* hypoglycaemic coma
* acute or acute on chronic liver failure, liver transplantation or end-stage liver disease.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Catholic University of the Sacred Heart

OTHER

Sponsor Role lead

Responsible Party

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Francesca Di Muzio

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Francesca Di Muzio

Role: CONTACT

0467556315; 00393470333656

References

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Cely CM, Arora P, Quartin AA, Kett DH, Schein RM. Relationship of baseline glucose homeostasis to hyperglycemia during medical critical illness. Chest. 2004 Sep;126(3):879-87. doi: 10.1378/chest.126.3.879.

Reference Type BACKGROUND
PMID: 15364770 (View on PubMed)

Kalfon P, Le Manach Y, Ichai C, Brechot N, Cinotti R, Dequin PF, Riu-Poulenc B, Montravers P, Annane D, Dupont H, Sorine M, Riou B; CGAO-REA Study Group. Severe and multiple hypoglycemic episodes are associated with increased risk of death in ICU patients. Crit Care. 2015 Apr 8;19(1):153. doi: 10.1186/s13054-015-0851-7.

Reference Type BACKGROUND
PMID: 25888011 (View on PubMed)

Egi M, Bellomo R, Stachowski E, French CJ, Hart GK, Hegarty C, Bailey M. Blood glucose concentration and outcome of critical illness: the impact of diabetes. Crit Care Med. 2008 Aug;36(8):2249-55. doi: 10.1097/CCM.0b013e318181039a.

Reference Type BACKGROUND
PMID: 18664780 (View on PubMed)

Krinsley JS, Egi M, Kiss A, Devendra AN, Schuetz P, Maurer PM, Schultz MJ, van Hooijdonk RT, Kiyoshi M, Mackenzie IM, Annane D, Stow P, Nasraway SA, Holewinski S, Holzinger U, Preiser JC, Vincent JL, Bellomo R. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study. Crit Care. 2013 Mar 1;17(2):R37. doi: 10.1186/cc12547.

Reference Type BACKGROUND
PMID: 23452622 (View on PubMed)

Plummer MP, Bellomo R, Cousins CE, Annink CE, Sundararajan K, Reddi BA, Raj JP, Chapman MJ, Horowitz M, Deane AM. Dysglycaemia in the critically ill and the interaction of chronic and acute glycaemia with mortality. Intensive Care Med. 2014 Jul;40(7):973-80. doi: 10.1007/s00134-014-3287-7. Epub 2014 Apr 24.

Reference Type BACKGROUND
PMID: 24760120 (View on PubMed)

Sulter G, Elting JW, De Keyser J. Increased serum neuron specific enolase concentrations in patients with hyperglycemic cortical ischemic stroke. Neurosci Lett. 1998 Aug 28;253(1):71-3. doi: 10.1016/s0304-3940(98)00595-3.

Reference Type BACKGROUND
PMID: 9754808 (View on PubMed)

Krinsley JS, Meyfroidt G, van den Berghe G, Egi M, Bellomo R. The impact of premorbid diabetic status on the relationship between the three domains of glycemic control and mortality in critically ill patients. Curr Opin Clin Nutr Metab Care. 2012 Mar;15(2):151-60. doi: 10.1097/MCO.0b013e32834f0009.

Reference Type BACKGROUND
PMID: 22234163 (View on PubMed)

Krinsley JS, Preiser JC. Time in blood glucose range 70 to 140 mg/dl >80% is strongly associated with increased survival in non-diabetic critically ill adults. Crit Care. 2015 Apr 20;19(1):179. doi: 10.1186/s13054-015-0908-7.

Reference Type BACKGROUND
PMID: 25927986 (View on PubMed)

Kochanek PM, Berger RP, Bayir H, Wagner AK, Jenkins LW, Clark RS. Biomarkers of primary and evolving damage in traumatic and ischemic brain injury: diagnosis, prognosis, probing mechanisms, and therapeutic decision making. Curr Opin Crit Care. 2008 Apr;14(2):135-41. doi: 10.1097/MCC.0b013e3282f57564.

Reference Type BACKGROUND
PMID: 18388674 (View on PubMed)

NICE-SUGAR Study Investigators; Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, Bellomo R, Cook D, Dodek P, Henderson WR, Hebert PC, Heritier S, Heyland DK, McArthur C, McDonald E, Mitchell I, Myburgh JA, Norton R, Potter J, Robinson BG, Ronco JJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009 Mar 26;360(13):1283-97. doi: 10.1056/NEJMoa0810625. Epub 2009 Mar 24.

Reference Type BACKGROUND
PMID: 19318384 (View on PubMed)

Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet. 2009 May 23;373(9677):1798-807. doi: 10.1016/S0140-6736(09)60553-5.

Reference Type BACKGROUND
PMID: 19465235 (View on PubMed)

Other Identifiers

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Gly 1

Identifier Type: -

Identifier Source: org_study_id

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