ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1682970
This article is part of the Research TopicData Science in Anesthesiology and Intensive CareView all articles
Prognostic Value of Mean Glycemia and Glycemic Variability in Medical, Surgical, and Cardiovascular Intensive Care Units at a Lebanese Tertiary Care Center
Provisionally accepted
Rachad Abou Daher1,2
Christy Salameh1,2
Nada El Ghorayeb1,2
Maissa Safieddine1,2
Marie-Hélène GANNAGE-YARED1,2*- 1Hôtel-Dieu de France, Beirut, Lebanon
- 2Universite Saint-Joseph de Beyrouth, Beirut, Lebanon
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Background and Objectives: Stress-induced hyperglycemia is common in intensive care units (ICUs) and has been linked to adverse outcomes. Although mean glycemia (MG) has been extensively studied, the benefits of strict glycemic control remain controversial, and the impact of glycemic variability (GV) is less clearly defined. No consensus currently exists regarding GV thresholds, and limited evidence is available across different ICU settings, with data from the Middle East region particularly lacking. This study aimed to assess the relationship between MG and GV with key clinical outcomes, including hospital and ICU length of stay (LOS), renal function, and in-hospital mortality, among patients admitted to three ICUs at a Lebanese tertiary care center. Methods: We retrospectively reviewed the medical records of patients admitted during July and August 2024 to the surgical, medical, and cardiovascular ICUs at the Hôtel-Dieu de France Hospital. Baseline characteristics, MG, GV, total hospital/ICU LOS, in-hospital mortality, and glomerular filtration rates (GFR) were analyzed. Results: GV was significantly associated with prolonged total and ICU LOS, reduced GFR, and increased in-hospital mortality. Patients with GV >30% had a markedly higher risk of death. In contrast, no significant association was found between MG and said outcomes. MG differed across ICU subunits, reaching its highest levels in the cardiovascular ICU, while GV did not vary significantly between units. Conclusion: GV, rather than MG, emerged as a key predictor of adverse outcomes in ICU patients, being associated with longer hospital and ICU LOS, renal impairment, and increased mortality. These findings highlight GV as an important therapeutic target in the management of critically ill patients.
Keywords: Mean Glycemia, Glycemic variability, Intensive Care Unit, Length of Stay, Mortality
Received: 10 Aug 2025; Accepted: 24 Sep 2025.
Copyright: © 2025 Abou Daher, Salameh, El Ghorayeb, Safieddine and GANNAGE-YARED. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marie-Hélène GANNAGE-YARED, mariehelene.yared@usj.edu.lb
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