Comparison of glucose variability measures

Glycemic excursion or Glucose Variability (GV) is associated with short term ICU mortality. There is heterogeneity among studies in using measures of GV. The objective of this study was to compare different formulas used to assess GV in predicting mortality.
The study was done in a 45 bed medical-surgical unit. All patients who were admitted to ITU and had 4 or more blood glucose (BG) readings were included from January 2009 to November 2009. Sugar control was protocolised with a target CBG of ≤ 150mg/dl. Glucose was measured from central laboratory or point of care checking at an interval
of 6 hours or when required. From the prospectively collected glucose values different measures of glycemic variability have been calculated and compared among themselves. We used SD (Standard Deviation), GLI (Glycemic Lability Index), MGC (Maximum Glucose Change), MAGE (Mean Amplitude of Glucose Excursion) and ADRR (Average Daily Risk Range) as measures of the glucose variability.

A total of 11,335 blood sugar records were analyzed from 2208 patients during this time. Mean age of the study population was 61(SD ± 16.71). 58.96 % were male and 77.8% were medical admission. Mean APACHE IV was 56.9. All the variables of glucose variability could predict mortality with equal power.
All the glucose variability measures have almost the same prediction power. Anyone of the measures can be used as quality indicator of glucose variability in an ICU.