Despite a significant increase in the number of patients with diabetes mellitus and impaired carbohydrate tolerance, as well as the existing relationship between these conditions and an increased risk of developing blood circulation infections, the amount of information on the level of control blood sugar levels, the time it takes to detect high blood sugar and the risk of developing infections in the bloodstream are limited. Therefore, the relevance of the study, in which the effect of short-term and long-term glycemic control on the development of nosocomial infections of the blood circulation, was analyzed, is quite understandable.

During the literature review at the time of admission to medical facilities in New York, 19,000 patients with diabetes mellitus and 61,000 patients with impaired carbohydrate tolerance, the researchers recorded a maximum rise in blood sugar on 3 overlapping time intervals from the day the infection started: from the specified date to 2 days before the start (day 0 - day -2); from day -1 to day -3; and from day -2 to day -4.

The short-term maximum increases in blood sugar were divided into the following categories: less than 80 mg / dl (less than 4.4 mmol / l), 80-109 mg / dl (4.4-6 mmol / l) , 110-139 mg / dl (6, 1-7.6 mmol / L), 140-179 mg / dl (7.7-9.9 mmol / L), 180-199 mg / dl (10-11 mmol / L) and 200 mg / dl (11.1 mmol / L) and above. HbA1c levels have been used as an indicator of long-term glycemic control. The infections of the blood circulation were confirmed by a positive result of the selected blood culture, provided that this microorganism is absent in the study of other biological media 14 days before the blood culture.

Using multivariate analysis to monitor demographic indicators, concomitant pathology, and medical diagnostic procedures in a hospital, a group of researchers discovered that the blood sugar level of 110 mg / dl (6.1 mmol / L) and older was most closely associated with the onset of infectious diseases. both in patients with diabetes mellitus and in people with reduced carbohydrate tolerance. However, there was no association between the risk of developing infections in the bloodstream and the blood sugar level determined more than 2 days before the onset of the infectious disease. When previous multivariate analyzes were performed in fewer patients with diabetes mellitus (n = 14,913), short-term blood glucose levels of 110 to 139 mg / dl (6.1-7.6 mmol / l) were associated with more than double the risk of developing blood circulation infections.

According to the researchers, short-term hyperglycemia is only a consequence of the development of a blood circulation infection and not an etiological factor. Therefore, in order to prevent the development of blood circulation infections, clinicians should consider high blood glucose levels.

However, this study did not reveal how short-term glycemic control in hospital patients will affect the likelihood of developing nosocomial infections in the bloodstream.

The results obtained during the study are interesting mainly because there was no relationship between long-term recorded hyperglycemia and the risk of developing infections of the blood circulation, while hyperglycemia in patients with 3 days after the start of infection was directly correlated with the probability of developing this group of diseases.

To date, a number of studies in the field of cardiac surgery have been conducted, in which glycemic control over the period of time affecting a particular procedure has reduced the risk of developing local surgical infections. However, in patients with diabetes mellitus, it is necessary to take into account the difficulties of glycemic control in the development of an infectious disease. Researchers have expressed doubts that short-term hyperglycemia increases the risk of blood infections. Most likely, this is only an early marker of infection, which was identified based on the positive results of a blood culture study.

In patients with diabetes mellitus, the development of an infectious disease makes it much more difficult to control the blood sugar level. But, at the same time, overly careful blood sugar control can lead to dangerous consequences, so you need to be as careful as possible in this regard.