Is acute hyperglycemia simply an acute phase reactant?

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-823
Divya Yogi-Morren*1, Karla Arce2, Marlow Hernandez2 and Carmen Vanessa Villabona3
1Cleveland Clinic Foundation, Cleveland, OH, 2Cleveland Clinic Florida, 3Cleveland Clinic Florida, Ft. Lauderdale, FL
Objective:

To evaluate the correlation between acute hyperglycemia and established acute phase reactants: C-reactive protein (CRP), Westergren Sedimentation Rate (WSR), ferritin levels and platelet count.

Background:

The term stress hyperglycemia, is usually defined as hyperglycemia resolving spontaneously after resolution of acute illness. In this regard acute hyperglycemia is seen as merely an acute phase reactant. However, in a significant proportion of patients it may indicate incipient diabetes and should not be trivialized. If stress hyperglycemia is truly reactive to acute illness then there should be a significant correlation between hyperglycemia and other markers of acute intercurrent illness including CRP, WSR, ferritin levels and thrombocytosis.

 

Methods:

This was a retrospective chart review study of patients admitted to the Cleveland Clinic Florida between January 2009 and December 2011, age >18yrs and not previously diagnosed with diabetes mellitus (DM). Of those so identified, 1200 patients were then randomly selected for chart review yielding 296 patients with CRP values and platelet counts, 180 patients with ESR values and 6 patients with ferritin levels. 

 

Results:

Statistical analysis showed that there was no correlation between blood glucose and CRP, WSR and platelets. The correlation coefficients between blood glucose and CRP, WSR and platelets were 0.11 (p=0.06, n=296), -0.04 (p=0.56, n=180) and 0.03 (p=0.66, n=296) respectively.

There was a statistically significant correlation between WSR and CRP (p=0.0001) and between WSR and platelets (p=0.001).

Conclusion:

The lack of statistically significant correlation between glucose and the acute phase reactants challenges the concept that acute hyperglycemia is a similar marker of acute illness. Acute hyperglycemia should then evoke more concern since it may reflect serious metabolic dysregulation. Therefore, when we encounter hyperglycemia in a hospitalized patient we should not assume this is related to “stress” and the patient should be evaluated for diabetes mellitus

Nothing to Disclose: DY, KA, MH, CVV

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm