The impact of acute glycemic index on the outcome in septic patients with presence of diabetes.

• Project/Area Number: 16K10936
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Kobe University
• Principal Investigator: EGI MORITOKI 神戸大学, 医学研究科, 准教授 (20423296)
• Co-Investigator(Kenkyū-buntansha): 廣田 勇士 神戸大学, 医学部附属病院, 助教 (80566018)
• Research Collaborator: Wakabayashi Junji ; Furushima Nana ; Hokka Mai ; Mizobuchi Satoshi
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 血糖 / 変動 / 敗血症 / 糖尿病 / 好中球機能 / 酸化ストレス / 血糖管理 / 急性期 / 血糖変動

Outline of Final Research Achievements

We observed HbA1c level in septic patients required intensive care more than 48 hours. We have measured blood glucose using continuous glucose monitoring for first 48 hours. We performed regression analysis between various glycemic indices and neutrophil function and oxidative stress. We found that there are significant relationship between relative hypoglycemia and Neutrophil sterilizing ability （r=0.503, p<0.01). We also found that there are significant association between the mean amplitude of glycemic excursions (MAGE) as index of glycemic variability and oxidative stress （r=0.412, p<0.01).

Academic Significance and Societal Importance of the Research Achievements

本研究では、敗血症診療の初期における血糖管理において、敗血症発症前の血糖管理を加味した血糖降下指数と好中球機能および酸化ストレスとの関係を検討した。敗血症診療中の血糖そのものだけではなく、病前血糖値を加味した指数の方が好中球機能および酸化ストレスとより強い関連を示した。これらの結果は、敗血症診療における至適な血糖管理を検討する上で、有益な情報であり、新たな血糖管理目標を提言する上で重要な情報となりうる。

Research Products

• [Journal Article] Acute glycemic control in diabetics. How sweet is optimal? Con: Just as sweet as in nondiabetic is better (2018)
  • Author(s): Egi Moritoki
  • Journal Title: Journal of Intensive Care Volume: 6 Issue: 1 Pages: 70-70
  • DOI: 10.1186/s40560-018-0337-1
  • NAID: 120006539307
  • Peer Reviewed / Open Access
• [Journal Article] Glycated hemoglobin A1c level on the day of emergency surgery is a marker of premorbid glycemic control: a retrospective observational study (2018)
  • Author(s): Hokka Mai、Egi Moritoki、Mizobuchi Satoshi
  • Journal Title: BMC Anesthesiology Volume: 18 Issue: 1 Pages: 180-180
  • DOI: 10.1186/s12871-018-0641-2
  • NAID: 120006545102
  • Peer Reviewed / Open Access
• [Journal Article] Glycemic control in acute illness (2017)
  • Author(s): Egi Moritoki、Furushima Nana、Makino Shohei、Mizobuchi Satoshi
  • Journal Title: Korean Journal of Anesthesiology Volume: 70 Issue: 6 Pages: 591-591
  • DOI: 10.4097/kjae.2017.70.6.591
  • NAID: 120006550261
  • Peer Reviewed / Open Access
• [Journal Article] The optimal target for acute glycemic control in critically ill patients: a network meta-analysis. (2017)
  • Author(s): Yatabe T, Inoue S, Sakaguchi M, Egi M.
  • Journal Title: Intensive care medicine Volume: ４３（１） Issue: 1 Pages: 16-28
  • DOI: 10.1007/s00134-016-4558-2
  • Peer Reviewed
• [Journal Article] Pre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality. (2016)
  • Author(s): Egi M, Krinsley JS, Maurer P, Amin DN, Kanazawa T, Ghandi S, Morita K, Bailey M, Bellomo R.
  • Journal Title: Intensive care medicine Volume: ４２（４） Issue: 4 Pages: 562-71
  • DOI: 10.1007/s00134-016-4216-8
  • Int'l Joint Research
• [Presentation] Postoperative Relative Increase of Blood Glucose Level in Patients with Premorbid Hyperglycemia; Its Association with the Risk of Delirium after Cardiac Surgery (2018)
  • Author(s): Nana Furushima, Moritoki Egi, Mai Hokka, Momoka Tonan, Daichi Fujimoto, Satoshi Mizobuchi
  • Organizer: American Society of Anesthesiologists Annual Meeting
  • Int'l Joint Research
• [Presentation] Incidence of intraoperative hypoglycemia during aortic arch replacement using cardioplegic solution with a low glucose concentration: effect of circulatory arrest (2018)
  • Author(s): Junji Wakabayashi, Moritoki Egi, Kenta Kubota, Satoshi Mizobuchi
  • Organizer: Euroanaesthesia 2018
  • Int'l Joint Research
• [Presentation] 心臓血管手術後患者において、術前予測平均血糖を基準とした相対的術後血糖上昇率は術後せん妄発生と相関する (2018)
  • Author(s): 古島夏奈、江木盛時、東南杏香、藤本大地、法華真衣、溝渕知司
  • Organizer: 日本麻酔科学会第65回学術集会
• [Presentation] 糖尿病患者の急性期血糖管理は、非糖尿病患者と同様で良い (2017)
  • Author(s): 江木盛時
  • Organizer: 第45回日本集中治療医学会学術集会
  • Invited
• [Presentation] Glycemic control in critically ill patients (2017)
  • Author(s): Moritoki Egi
  • Organizer: Asian Transplantation Week
  • Int'l Joint Research / Invited
• [Presentation] 集中治療患者における体温管理・血糖管理 (2017)
  • Author(s): 江木盛時
  • Organizer: 第45回日本救急医学会総会・学術集会
  • Invited
• [Presentation] Glycated hemoglobin A1c on the day of emergency surgery is a marker of premorbid glycemic control. (2016)
  • Author(s): Mai Hokka, Moritoki Egi, Satoshi Mizobuchi
  • Organizer: 29th Annual Congress of theEuropean Society of Intensive Care Medicine(
  • Place of Presentation: Milan
  • Year and Date: 2016-10-01
  • Int'l Joint Research
• [Presentation] Moritoki Egi (2016)
  • Author(s): The Glucose Control in Critically ill with diabetic mellitus
  • Organizer: The 35th Annual Conference of the KSCCM, The 16th Joint Scientific Congress of the KSCCM and JSICM
  • Place of Presentation: Seoul
  • Year and Date: 2016-04-22
  • Int'l Joint Research / Invited
• [Remarks] 業績紹介
  • URL: http://www.med.kobe-u.ac.jp/anes/duties.html