HbA1C in ICU

Introduction:

HbA1c is widely used as a marker of glycaemic control and has been proposed and used, but not yet officially accepted, as a diagnostic marker for diabetes. We have tested its usefulness for diagnosing diabetes in the intensive care setting.

Methods

All patients with negative history for DM and hyperglycaemia in ICU were called for measurement of fasting glucose and OGTT within 1 month after discharge.

Results

There were 618 patients in the cohort:  293 patients had hyperglycaemia during the ICU stay and no information about DM in the history. Cut-off of 6% had 97% sensitivity and 93% specificity for pre-diabetes, 7% cut-off had 95% sensitivity and 98% specificity for DM.

Conclusions

HbA1c can be used for diagnosing diabetes and pre-diabetes in patients with critical care hyperglycaemia with high sensitivity and specificity. 

Reference:

I Gornik, A Vujaklija-Brajković and V Gašparović - Validation of HbA1c as a diagnostic marker for diabetes in the critically ill -Critical Care 2010, 14(Suppl 1):P581