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The impact of glycemic variability in critically ill patients

Research Project

Project/Area Number 21689041
Research Category

Grant-in-Aid for Young Scientists (A)

Allocation TypeSingle-year Grants
Research Field Anesthesiology/Resuscitation studies
Research InstitutionOkayama University

Principal Investigator

EGI Moritoki  岡山大学, 岡山大学病院, 助教 (20423296)

Project Period (FY) 2009 – 2011
Project Status Completed (Fiscal Year 2011)
Budget Amount *help
¥8,580,000 (Direct Cost: ¥6,600,000、Indirect Cost: ¥1,980,000)
Fiscal Year 2011: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Fiscal Year 2010: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Fiscal Year 2009: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Keywords集中治療 / 血糖 / 変動 / インスリン
Research Abstract

The aim of these studies are 1) to evaluate the impact of glycemic variability on the patients outcomes, 2) to determine whether changing glycemic control could be eliminate glycemic variability and 3) to study whether reduction of glycemic variability would improve patients outcomes in critically ill patients.
To achieve these aims, we conducted 5 studies for 3 years. First, we monitored glycemic variability using continuous glucose monitoring devices and assessed its association with oxidative stress and chemical mediators in adult cardiac surgery patients. Second, we evaluated glycemic variability by 6 hourly glucose monitoring and determined its relationship with outcomes in postoperative critically ill patients. Third, we change protocol for insulin driven and enteral nutrition formula from normal diet to it for diabetes. Then, we evaluate the glycemic variability between them. Fourth, we also evaluate whether such a reduction of glycemic variability could changes perioperative oxidative stress and inflammatory response. Finally, we evaluated the glycemic gap between pre-admission and post-admission glucose control in critically ill patients with diabetes.
Through these studies, we found that glycemic variability in critically ill patients had strong association with oxidative stress, inflammatory response and outcomes. Additionally, we can show that alternation of glycemic control could eliminate the glycemic variability.

Report

(4 results)
  • 2011 Annual Research Report   Final Research Report ( PDF )
  • 2010 Annual Research Report
  • 2009 Annual Research Report
  • Research Products

    (67 results)

All 2012 2011 2010 2009

All Journal Article (29 results) (of which Peer Reviewed: 19 results) Presentation (37 results) Book (1 results)

  • [Journal Article] The impact of premorbid diabetic status on the relationship between the three domains of glycemic control and mortality in critically ill patients2012

    • Author(s)
      Krinsley JS, Meyfroidt G, van den Berghe G, Egi M, Bellomo R
    • Journal Title

      Curr Opin Clin Nutr Metab Care

      Volume: 15(2) Pages: 151-60

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] The impact of premorbid diabetic status on the relationshio between the three domains of glycemic control and mortal critically ill2012

    • Author(s)
      Krinsley JS
    • Journal Title

      Curr Opin Clin Nutr Metab Care

      Volume: 15 Pages: 151-160

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Hypoglycemia in sepsis : biomarker, mediator, or both?2011

    • Author(s)
      Bellomo R, Egi M
    • Journal Title

      Crit Care Med

      Volume: 39(10) Pages: 2367-9

    • Related Report
      2011 Final Research Report
  • [Journal Article] Glycemic control in the ICU2011

    • Author(s)
      Egi M, Finfer S, Bellomo R
    • Journal Title

      Chest

      Volume: 140(1) Pages: 212-20

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Blood glucose control incritically ill perioperative patients2011

    • Author(s)
      Egi M
    • Journal Title

      Masui

      Volume: 60(3) Pages: 285-92

    • Related Report
      2011 Final Research Report
  • [Journal Article] The interaction of chronic and acute glycemia with mortality in critically ill patients with diabetes2011

    • Author(s)
      Egi M, Bellomo R, Stachowski E, et al
    • Journal Title

      Crit Care Med

      Volume: 39(1) Pages: 105-11

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Glycemic control in the ICU2011

    • Author(s)
      Moritoki Egi, et al
    • Journal Title

      Chest

      Volume: 140 Pages: 212-220

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Hypoglycemia in sepsis : biomarker, mediator, or both?2011

    • Author(s)
      Bellomo R
    • Journal Title

      Crit Care Med

      Volume: 39 Pages: 170-813

    • Related Report
      2011 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 経口血糖降下薬2011

    • Author(s)
      江木盛時
    • Journal Title

      臨床麻酔

      Volume: 35 Pages: 699-704

    • Related Report
      2011 Annual Research Report
  • [Journal Article] 糖尿病患者の急性期血糖管理2011

    • Author(s)
      江木盛時
    • Journal Title

      臨床麻酔

      Volume: 35 Pages: 950-955

    • Related Report
      2011 Annual Research Report
  • [Journal Article] The interaction of chronic and acute glycemia with mortality in critically ill patients with diabetes.2011

    • Author(s)
      Moritoki Egi
    • Journal Title

      Critical care medicine

      Volume: 39(1) Pages: 105-111

    • Related Report
      2010 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 周術期の血糖管理2011

    • Author(s)
      江木盛時
    • Journal Title

      麻酔

      Volume: 60(3) Pages: 285-292

    • Related Report
      2010 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Hypoglycemia and outcome in critically ill patients2010

    • Author(s)
      Egi M, Bellomo R, Stachowski E, et al
    • Journal Title

      Mayo Clin Proc

      Volume: 85(3) Pages: 217-24

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Safer glycemic control using isomaltulose-based enteral formula : a pilot randomized crossover trial2010

    • Author(s)
      Egi M, Toda Y, Katayama H, et al
    • Journal Title

      J Crit Care

      Volume: 25(1) Pages: 90-6

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Hypoglycemia and outcome in critically ill patients.2010

    • Author(s)
      Moritoki Egi
    • Journal Title

      Mayo Clin Proc

      Volume: 2010 Pages: 217-224

    • Related Report
      2010 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 敗血症患者の血糖管理2010

    • Author(s)
      江木盛時
    • Journal Title

      救急医学 34

      Pages: 323326-323326

    • Related Report
      2009 Annual Research Report
  • [Journal Article] 急性血糖管理の最前線2010

    • Author(s)
      江木盛時
    • Journal Title

      臨床麻酔 34

      Pages: 531538-531538

    • Related Report
      2009 Annual Research Report
  • [Journal Article] Reducing glycemic variability in intensive care unit patients : a new therapeutic target?2009

    • Author(s)
      Egi M, Bellomo R
    • Journal Title

      J Diabetes Sci Technol

      Volume: 3(6) Pages: 1302-8

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] The impact of early hypoglycemia and blood glucose variability on outcome in critical illness2009

    • Author(s)
      Bagshaw SM, Bellomo R, Jacka MJ, Egi M, et al
    • Journal Title

      Crit Care

      Volume: 13(3)

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Anesthetic management of pediatric patients with insulinoma using continuous glucose monitoring2009

    • Author(s)
      Manabe M, Morimatsu H, Egi M, et al
    • Journal Title

      Masui

      Volume: 58(6) Pages: 757-9

    • NAID

      40016698422

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] Is reducing variability of blood glucose the real but hidden target of intensive insulin therapy?2009

    • Author(s)
      Egi M, Bellomo R, Reade MC
    • Journal Title

      Crit Care

      Volume: 13(2) Pages: 302-302

    • Related Report
      2011 Final Research Report
    • Peer Reviewed
  • [Journal Article] 重症患者における血糖変動2009

    • Author(s)
      江木盛時
    • Journal Title

      Nutritional Support Journal 10

      Pages: 710-710

    • Related Report
      2009 Annual Research Report
  • [Journal Article] 重症患者の血糖管理の動向2009

    • Author(s)
      江木盛時
    • Journal Title

      救急医学 33

      Pages: 17741778-17741778

    • Related Report
      2009 Annual Research Report
  • [Journal Article] What is a NICE SUGAR for ICU Patients?2009

    • Author(s)
      江木盛時
    • Journal Title

      外科と代謝・栄養 43

      Pages: 187192-187192

    • NAID

      10026098275

    • Related Report
      2009 Annual Research Report
  • [Journal Article] 重症患者の血糖管理2009

    • Author(s)
      江木盛時
    • Journal Title

      四国医学雑誌 65

      Pages: 711-711

    • Related Report
      2009 Annual Research Report
  • [Journal Article] What is a NICE-SUGAR for patients in the intensive care unit?2009

    • Author(s)
      Bellow Rinaldo
    • Journal Title

      Mayo Clin Proc. 84

      Pages: 400402-400402

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Is reducing variability of blood glucose the real but hidden target of intensive insulin therapy?2009

    • Author(s)
      Moritoki Egi
    • Journal Title

      Critical Care 13

      Pages: 302302-302302

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Safer glycemic control using isomaltulose-based enteral formula : a pilot randomized crossover trial.2009

    • Author(s)
      Moritoki Egi
    • Journal Title

      Journal of Critical Care 25

      Pages: 9096-9096

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Reducing glycemic variability in intensive care unit patients : a new therapeutic target?2009

    • Author(s)
      Moritoki Egi
    • Journal Title

      J Diabetes Sci Technol. 3

      Pages: 13021308-13021308

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Presentation] Glycemic control in diabetic patients2012

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      31th annual meeting of international society of intensive care and emergency medicine
    • Place of Presentation
      Brussels
    • Year and Date
      2012-03-24
    • Related Report
      2011 Final Research Report
  • [Presentation] Glucose control in diabetic patients2012

    • Author(s)
      Moritoki egi
    • Organizer
      32th ISICEM
    • Place of Presentation
      ベルギー
    • Year and Date
      2012-03-23
    • Related Report
      2011 Annual Research Report
  • [Presentation] パラチノース含有経腸栄養剤の周術期高血糖抑制効果;pilot randomized trial2012

    • Author(s)
      江木盛時
    • Organizer
      第39回日本集中治療医学会学術集会
    • Place of Presentation
      千葉
    • Year and Date
      2012-02-28
    • Related Report
      2011 Annual Research Report
  • [Presentation] Prevention of postoperative hyperglycemia using isomaltulose based enteral formula : A pilot randomized trial2012

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      Society of Critical Care Medicine's 41th Critical Care Congress
    • Place of Presentation
      Houston
    • Year and Date
      2012-02-07
    • Related Report
      2011 Final Research Report
  • [Presentation] 糖尿病患者の周術期血糖管理2011

    • Author(s)
      江木盛時
    • Organizer
      臨牀麻酔学会
    • Place of Presentation
      沖縄
    • Year and Date
      2011-11-03
    • Related Report
      2011 Annual Research Report
  • [Presentation] Long term survival after esophagectomy ; its association with anesthetic management2011

    • Author(s)
      Moritoki egi
    • Organizer
      第58回麻酔科学会学術集会
    • Place of Presentation
      神戸
    • Year and Date
      2011-05-20
    • Related Report
      2011 Annual Research Report
  • [Presentation] An Application of enteral nutrition protocol improves patients cares and outcomes in post esophagectomy patients2011

    • Author(s)
      Akira Hamada, Moritoki Egi, et al
    • Organizer
      Society of Critical Care Medicine's 40th Critical Care Congress
    • Place of Presentation
      San Diego
    • Year and Date
      2011-01-17
    • Related Report
      2011 Final Research Report
  • [Presentation] Perioperative Glucose Variability and Oxidative Stress in postoperative critically ill patients2011

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      Society of Critical Care Medicine's 40th Critical Care Congress
    • Place of Presentation
      San Diego
    • Year and Date
      2011-01-17
    • Related Report
      2011 Final Research Report
  • [Presentation] 重症患者の血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      奈良麻酔集中治療セミナー
    • Place of Presentation
      奈良
    • Year and Date
      2010-11-09
    • Related Report
      2010 Annual Research Report
  • [Presentation] 血糖管理の新時代2010

    • Author(s)
      江木盛時
    • Organizer
      麻酔科フォーラムin TOYAMA
    • Place of Presentation
      富山
    • Year and Date
      2010-10-29
    • Related Report
      2010 Annual Research Report
  • [Presentation] What is a NICE-SUGAR in ICU patients2010

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      8th IDF WPR
    • Place of Presentation
      Busan
    • Year and Date
      2010-10-20
    • Related Report
      2011 Final Research Report
  • [Presentation] What is a NICE-SUGAR in ICU patients2010

    • Author(s)
      江木盛時
    • Organizer
      The 8th International Diabetes Federation Western Pacific Region
    • Place of Presentation
      釜山
    • Year and Date
      2010-10-19
    • Related Report
      2010 Annual Research Report
  • [Presentation] 周術期の血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      日本麻酔科学会北海道・東北支部学術集会
    • Place of Presentation
      山形
    • Year and Date
      2010-09-10
    • Related Report
      2010 Annual Research Report
  • [Presentation] 糖尿病患者の急性期血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      周術期体液・代謝・侵襲研究会
    • Place of Presentation
      品川
    • Year and Date
      2010-08-07
    • Related Report
      2010 Annual Research Report
  • [Presentation] Launch into postoperative period beyond operation theater =Post operative long-term outcomes=2010

    • Author(s)
      江木盛時
    • Organizer
      日本麻酔科学会第57回学術集会
    • Place of Presentation
      福岡
    • Year and Date
      2010-06-05
    • Related Report
      2010 Annual Research Report
  • [Presentation] 敗血症患者における血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      日本麻酔科学会第57回学術集会
    • Place of Presentation
      福岡
    • Year and Date
      2010-06-04
    • Related Report
      2010 Annual Research Report
  • [Presentation] 敗血症患者に対する血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      日本感染症学会総会
    • Place of Presentation
      京都
    • Year and Date
      2010-04-05
    • Related Report
      2010 Annual Research Report
  • [Presentation] 血糖管理の新時代2010

    • Author(s)
      江木盛時
    • Organizer
      第14回 CCM輸液・栄養研究会
    • Place of Presentation
      東京
    • Year and Date
      2010-03-13
    • Related Report
      2009 Annual Research Report
  • [Presentation] 心臓手術周術期の血糖管理と酸化ストレスの関係:持続血糖測定を用いた検討2010

    • Author(s)
      江木盛時
    • Organizer
      第37回日本集中治療医学会学術集会
    • Place of Presentation
      広島
    • Year and Date
      2010-03-06
    • Related Report
      2009 Annual Research Report
  • [Presentation] Perioperative Glucose Variability and Oxidative Stress in Cardiac Surgery Patients2010

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      10th Joint congress of JSICM & KSCCM
    • Place of Presentation
      Hiroshima
    • Year and Date
      2010-03-05
    • Related Report
      2011 Final Research Report
  • [Presentation] 重症患者の血糖管理2010

    • Author(s)
      江木盛時
    • Organizer
      CAN(Chiba Anesthesiologists Network)周術期管理セミナー
    • Place of Presentation
      千葉
    • Year and Date
      2010-03-05
    • Related Report
      2010 Annual Research Report
  • [Presentation] Perioperative Glucose Variability and Oxidative Stress in Cardiac Surgery Patients2010

    • Author(s)
      Moritoki Egi
    • Organizer
      10th joint congress of JSICM & KSCCM
    • Place of Presentation
      広島
    • Year and Date
      2010-03-04
    • Related Report
      2009 Annual Research Report
  • [Presentation] 食道癌術後患者の周術期血糖変動と酸化ストレスの関係2010

    • Author(s)
      江木盛時
    • Organizer
      第38回日本集中治療医学会学術集会
    • Place of Presentation
      横浜
    • Year and Date
      2010-02-25
    • Related Report
      2010 Annual Research Report
  • [Presentation] What is a NICE-SUGAR in perioperative patients2010

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      LSA-JSA Joint meeting
    • Place of Presentation
      Laos
    • Year and Date
      2010-02-12
    • Related Report
      2011 Final Research Report
  • [Presentation] What is a NICE-SUGAR in perioperative patients2010

    • Author(s)
      Moritoki Egi
    • Organizer
      ラオス麻酔科学会・日本麻酔科学会Joint meeting
    • Place of Presentation
      ラオス・ビエンチェン
    • Year and Date
      2010-02-12
    • Related Report
      2009 Annual Research Report
  • [Presentation] SSI予とICU重症患者での血糖管理の相連点2010

    • Author(s)
      江木盛時
    • Organizer
      第25回日本環境感染学会総会
    • Place of Presentation
      品川
    • Year and Date
      2010-02-05
    • Related Report
      2009 Annual Research Report
  • [Presentation] これからの急性血糖管理としての"Tight" glucose control;今後、人工すい臓は必要か?2010

    • Author(s)
      江木盛時
    • Organizer
      第27回日本集中治療医学会中国四国地方会
    • Place of Presentation
      高知
    • Year and Date
      2010-01-30
    • Related Report
      2009 Annual Research Report
  • [Presentation] Perioperative Glucose Variability and Oxidative Stress in postoperative critically ill patients2010

    • Author(s)
      江木盛時
    • Organizer
      Society of Critical Care Medicine's 40th Critical Care Congress
    • Place of Presentation
      San diego
    • Year and Date
      2010-01-16
    • Related Report
      2010 Annual Research Report
  • [Presentation] PERIOPERATIVE GLUCOSE VARIABILITY AND OXIDATIVE STRESS IN CARDIAC SURGERY PATIENTS2010

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      Society of Critical Care Medicine's 39th Critical Care Congress
    • Place of Presentation
      Miami
    • Year and Date
      2010-01-10
    • Related Report
      2011 Final Research Report
  • [Presentation] PERIOPERATIVE GLUCOSE VARIABILITY AND OXIDATIVE STRESS IN CARDIAC SURGERY PATIENTS.2010

    • Author(s)
      Moritoki Egi
    • Organizer
      Society of Critical Care Medicine's 39th Critical CareCongress
    • Place of Presentation
      米国・マイアミ
    • Year and Date
      2010-01-09
    • Related Report
      2009 Annual Research Report
  • [Presentation] 重症患者の血糖管理;Leaven vs. NICE-SUGAR2009

    • Author(s)
      江木盛時
    • Organizer
      京都セプシスフォーラム
    • Place of Presentation
      京都
    • Year and Date
      2009-12-19
    • Related Report
      2009 Annual Research Report
  • [Presentation] 血糖管理の新時代:What is a NICE-SUGAR for perioperative patients?2009

    • Author(s)
      江木盛時
    • Organizer
      日本臨床麻酔学会 第29回大会
    • Place of Presentation
      浜松
    • Year and Date
      2009-10-30
    • Related Report
      2009 Annual Research Report
  • [Presentation] Glucose Variability and Oxidative Stress during Cardio-Pulmonary Bypass2009

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      Annual meeting American society of anesthesiologist
    • Place of Presentation
      New Orleans
    • Year and Date
      2009-10-19
    • Related Report
      2011 Final Research Report
  • [Presentation] Glucose Variability and Oxidative Stress during Cardio-Pulmonary Bypass2009

    • Author(s)
      Moritoki Egi
    • Organizer
      Annual meeting of American society of anesthesiology
    • Place of Presentation
      米国・ニューオリンズ
    • Year and Date
      2009-10-19
    • Related Report
      2009 Annual Research Report
  • [Presentation] 人工心肺中の血糖変動と術後腎不全:持続血糖測定を用いた評価2009

    • Author(s)
      江木盛時
    • Organizer
      日本麻酔科学会第56回学術集会
    • Place of Presentation
      神戸
    • Year and Date
      2009-08-16
    • Related Report
      2009 Annual Research Report
  • [Presentation] What is a NICE-SUGAR for ICU patients2009

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      The 29th Annual Conference of the Korean Society of Critical Care Medicine and the 9th Joint Scientific Congress of the KSCCM and JSICM
    • Place of Presentation
      Seoul
    • Year and Date
      2009-04-24
    • Related Report
      2011 Final Research Report
  • [Presentation] THE PALATINOSE BASED ENTERAL FORMULA ON POST SURGICAL HYPERGLYCEMIA ; RANDOMIZED CROSS-OVER TRIAL2009

    • Author(s)
      Moritoki Egi, et al
    • Organizer
      The 29th Annual Conference of the Korean Society of Critical Care Medicine and the 9th Joint Scientific Congress of the KSCCM and JSICM
    • Place of Presentation
      Seoul
    • Year and Date
      2009-04-24
    • Related Report
      2011 Final Research Report
  • [Book] Control de glycemia en sepsis severa y shock septic. In Castro J, Hernandez G, Bruhn A, Romero C(eds) Sepsis y falla multiorganica2011

    • Author(s)
      Ligabo E., Egi M, Bellomo R
    • Publisher
      Editorial Mediterraneo
    • Related Report
      2011 Final Research Report

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Published: 2009-04-01   Modified: 2016-04-21  

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