Glycemic Gap Versus Admission Plasma Glucose Level As Predictors of ICU Out Comes in Type 2 Diabetic Patients With Acute Heart Failure

Study Overview
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Brief Summary
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assess the relation between glycemic gab and adverse clinical outcomes in diabetic patients who hospitalized with heart failure

Detailed Description
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Hyperglycemia is a common problem in patients wi9non-diabetic patients but not in patients with diabetes . The relationship between admission hyperglycemia and mortality in diabetic patients with AHF or critical illness remains controversial . Those discrepancies could be partly attributed to long-term glycemic control in diabetic patients. Critical illness can induce stress-induced hyperglycemia (SIH), which results from the excess release of counter-regulatory hormones and anti-inflammatory cytokines, leading to augmented gluconeogenesis and insulin resistance. In diabetic patients with acute illness, the phenomenon of admission hyperglycemia could be connected with acute physiological stress, poorer glycemic controls, or a combination of both . It is necessary to think about background glycemic control when exploring the relationships between admissions Hyperglycemia and clinical outcomes. Recent studies have shown that hemoglobin A1c (HbA1c)-based adjusted glycemic variables, including glycemic gap and stress hyperglycemia ratio, were linked to severity of disease and unfavorable prognosis in diabetic patients with some infectious diseases, cardiovascular diseases and clinical illness

Official Title
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Glycemic Gap Versus Admission Plasma Glucose Level As Predictors of ICU Out Comes in Type 2 Diabetic Patients With Acute Heart Failure

Conditions
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Assess the Relation Between Glycemic Gab and Adverse Clinical Outcomes in Diabetic Patients Who Hospitalized With Heart Failure

Intervention / Treatment
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* Device: glycemic gap


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All diabetic patients admitted to ICU of internal medicine department from October 2020 to November 2021 by heart failure Exclusion Criteria: Age ≤18 years. Hypoglycemia (plasma glucose <70 mg/dL) at initial presentation. An admission diagnosis of diabetic ketoacidosis or hyperosmolar hyperglycemic state. Patients with hemoglobin variants (e.g., sickle cell anemia, thalassemia) or with hematologic conditions (e.g., hemolytic anemia) that could interfere with the accuracy of the HbA1c assay.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: glycemic gap|Measurements of HbA1c-based adjusted glycemic gap: The estimated chronic average glucose levels (eAG) over the past 3 months will calculate from the equation AG = 28.7 × HbA1c - 46.7 Glycemic gap was calculated as the ADAG level subtracted from the admission glucose level.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Glycemic gap versus admission plasma glucose level As predictors of ICU out comes in type 2 diabetic patients with acute heart failure | Glycemic gap versus admission plasma glucose level As predictors of ICU out comes in type 2 diabetic patients with acute heart failure | through study completion an avarage 1 year |