Hypoglycemia in patients with community-acquired pneumonia at the time of hospital admission leads to a significant increase in the risk of death in the short and long term. These data were presented at the 20th World Congress of the International Diabetes Federation, which was held from October 18 to 22, 2009 in Montreal (Canada).

The main finding of researchers at the University of Alberta (Edmonton, Canada) (University of Alberta Edmonton) was that defining a laboratory indicator as simple as glucose is a very informative prognostic factor. nosocomial mortality and mortality for one year after illness in patients with community-acquired pneumonia. The determination of blood sugar can be considered as a simple and effective method to stratify patients according to risk factors and to intensify the subsequent management of patients with hypoglycemia present at the time of hospital admission.

The data on the increase in early mortality (30 days) in patients with community-acquired pneumonia and low serum glucose levels are consistent with the information published in the literature. At the same time, the effect of hypoglycemia on long-term mortality has been demonstrated for the first time.

In a study conducted on the basis of 6 hospitals in Edmonton (Canada), the data of all patients with community-acquired pneumonia hospitalized in the period from 2000 to 20002 were analyzed. Patients with glucose levels greater than 6.1 mmol / L (n = 1996) were excluded from the analysis.

Of the 956 patients included in the study, 54 people suffered from hypoglycemia (glucose level lower than 4.0 mmol / L) and 902 patients had normal blood glucose levels (4.0-6.1 mmol / L ). The average age of the patients was 65 years, 48% were women and 15% of the patients lived in nursing homes. Almost half of the patients (45%) had a severe course of pneumonia (assessment of the severity of pneumonia - PSI risk classes - IV or V). Eleven of 54 patients with hypoglycemia (20%) died during their hospital stay, compared to 78 of 902 patients (9%) in the control group (adjusted odds ratio 2.96, p = 0.005). Mortality in the group of patients with hypoglycemia compared to patients with normoglycemia was 20% and 10%, respectively, at day 30, and 30% and 14%, respectively, at 1 year.

According to the researchers, further studies should determine whether correcting hypoglycemia will improve the prognosis for patients with pneumonia.