A team of scientists researching diabetes has suggested that blood glucose levels should be considered the fifth vital sign in terms of general well-being for all hospital patients, regardless of whether they have diabetes or not.
The experts recommended this for all patients, regardless of their illness that led them to hospitalization. For more than 100 years, four vital signs – temperature, heart rate, blood pressure, and respiratory rate – have been routinely recorded by doctors and nurses to make decisions about a patient’s overall health.
The current recommendations, recently published in Diabetes and Metabolic Syndrome: Clinical Research and Reviews, a journal, come from a consensus group consisting of Padma Shri Prof Anoop Misra (New Delhi), Dr Akhtar Hussain (Norway, President Elect, International Diabetes Federation ), Dr Leszek Czupryniak (Chairman, Poland Diabetes Association), Dr Itamar Raz (Head, Israel National Council of Diabetes), Dr Banshi Saboo (President, RSSDI), Dr SR Aravind (President, DiabetesIndia), along with Dr Jothydev Kesavadev ( Trivandrum, Kerala), the group’s lead author.
The experts analyzed approximately 20 published studies and the recent robust data from Covid-19 hospital admissions around the world, Dr. Kesavadev on The Indian Express. Studies to date show that blood glucose, in the higher normal, mildly hyperglycemic or hypoglycemic range, adversely affects hospital outcomes in those not known to have prior diabetes. This may be especially important in developing countries where a significant number of individuals are at risk of developing hyperglycemia.
Blood glucose is a requirement for the body to maintain normal metabolic processes. Any deviation from normal blood glucose levels can have adverse effects and contribute to morbidity and mortality. Thus, blood glucose is one of the important parameters of prognosis in any disease, indicating that its documentation is an essential part of clinical monitoring, Dr. , explained.
“Despite not having diabetes, some Covid-19 patients, who have moderate or severe disease and are taking steroids, have high blood sugar. For example, I’m following a 41-year-old Covid-19 patient with no diabetes, but the patient’s blood sugar levels are 320, ”said Dr. Kesavadev as he explained the importance of adopting the new recommendation from doctors and nurses across all specialties to reduce the number. days and lower treatment costs in hospitals.
“Taking into account all the details, we say it is necessary to have a blood glucose test from the outset, especially in hospitalized patients regardless of diabetes. Blood glucose must be monitored, especially in patients who are moderately ill, ”said Prof. Misra, who was part of the consensus group.
Undiagnosed blood sugar is quite common in India. And the moment a patient in hospital care is under stress, the blood glucose level goes high, as many of them are pre-diabetic. It may also decrease in some cases or glucose variability can occur, ”added Prof Mishra. The team has been working on the study for the past two to three months, along with international experts.
Minimal variations in glucose, both high and low in patients without diabetes and pre-diabetes, have been conclusively proven to significantly increase the morbidity, severity and duration of hospital stays. Glucose variability (GV), defined as glucose levels below and above acceptable limits, appears to be directly related to the increasing severity of the underlying disease, even in individuals without diabetes.
Across the world, blood glucose is routinely only part of the protocol in individuals with established diabetes. However, if the glucose reading is followed for all diseases according to the recommendations, it is believed to drastically reduce progression to disease severity, number of days in hospital, and overall cost of treatment.
With Jayashree Narayanan in Pune