Impact of diabetes mellitus and its complications: survival and quality-of-life in critically ill patients

Purpose: Diabetes mellitus represents an increasing problem for patients and health care systems worldwide. We sought to investigate the effect of diabetes and its associated comorbidities on long-term survival and quality of life following an admission to a medical intensive care unit (ICU). Methods: A total of 6662 consecutive patients admitted to ICU between 2004 and 2009 were included (patients with diabetes n = 796, non-diabetic patients n = 5866). The primary endpoint of the study was death of any cause. Data on mortality was collected upon review of medical records or phone interviews. Moreover, a questionnaire was sent to 500 randomly selected patients addressing Health related Quality of Life (HrQoL) after ICU treatment. Results: Overall mortality did not differ significantly between diabetic and non-diabetic patients after ICU treatment (mean follow-up time: 490 days). For a subgroup of patients already exhibiting comorbidities associated with diabetes, the mortality rate was significantly higher (p = 0.022). Regarding quality of life, no differences were found between groups. Conclusions: Diabetes was not associated with increased mortality or reduced quality of life in a general population of medical ICU patients. However, once comorbidities associated with diabetes occurred, the survival rate of patients with comorbidities associated with hyperglycemia was significantly reduced. (C) 2015 Elsevier Inc. All rights reserved.