• Ali Abdelhamid Yasmine Y 0000-0002-3340-1965 Intensive Care Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. yasmine.aliab, Palash Kar, Mark E Finnis, Liza K Phillips, Mark P Plummer, Jonathan E Shaw, Michael Horowitz, and Adam M Deane.
• Intensive Care Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. yasmine.aliabdelhamid@adelaide.edu.au.
• Crit Care. 2016 Sep 27; 20 (1): 301.

BackgroundHyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes.MethodsWe searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge. Two reviewers independently screened the titles and abstracts of identified studies and evaluated the full text of relevant studies. Data were extracted using pre-defined data fields, and risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled ORs with 95 % CIs for the occurrence of diabetes were calculated using a random-effects model.ResultsFour cohort studies provided 2923 participants, including 698 with stress hyperglycaemia and 131 cases of newly diagnosed diabetes. Stress hyperglycaemia was associated with increased risk of incident diabetes (OR 3.48; 95 % CI 2.02-5.98; I 2  = 36.5 %). Studies differed with regard to definitions of stress hyperglycaemia, follow-up and cohorts studied.ConclusionsStress hyperglycaemia during ICU admission is associated with increased risk of incident diabetes. The strength of this association remains uncertain because of statistical and clinical heterogeneity among the included studies.

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