Association of Hyperglycemia with In-Hospital Mortality and Morbidity in Libyan Patients with Diabetes and Acute Coronary Syndromes

Systolic Blood Pressure, Blood Glucose, and Mortality of Patients with Acute Coronary Syndrome

BACKGROUND: Acute coronary syndrome (ACS) is a cardiovascular disease causing a high number of patient mortality in the world as well as Indonesia. Systolic blood pressure (SBP) and blood glucose (BG) are suspected to be important indicators for determining the risk stratification and prognostic information of ACS. AIM: This study aims to evaluate blood pressure and BG alongside the mortality of patients with ACS. METHODS: This was a quantitative study conducted using a retrospective survey method and the secondary data used were obtained from the medical records in Dr. Iskak Hospital between January and December 2020. The study sample consists of 110 respondents selected with a proportionate stratified random sampling. Meanwhile, the independent variables were SBP (X1) and BG (X2) while the dependent variable was mortality in ACS patients (Y). RESULTS: The multivariate analyses results with logistic regression show that SBP is associated with mortality with p = 0.008 and an odds ratio of 0.673. Furthermore, the BG was slightly higher in the multivariate model which has an odds ratio of 3.052 and was associated with mortality having p = 0.000. CONCLUSION: Based on the result, a low SBP and high BG lead to ACS patient mortality, consequently, serious attention is needed on the SBP and blood sugar.

Circulating MicroRNA Profiles Differ between Hyperglycemia and Euglycemia in Coronary Heart Disease Patients

Coronary heart disease (CHD) has become one of the leading causes of death and functional impairment in the world. Hyperglycemia is associated with an increased risk of cardiovascular disease. It was speculated that miRNAs in peripheral blood were a primary parameter in discriminating CHD. The biological characteristics of coronary heart disease with hyperglycemia (HCHD) and coronary heart disease with euglycemia (ECHD) were investigated in the study. Circulating miRNAs from 26 HCHD patients and 42 ECHD patients were identified by microarrays. Compared with the healthy patients, 15 and 20 differentially expressed miRNAs were identified in HCHD and ECHD groups, respectively. Gene ontology analysis was carried out by DAVID and functional annotations of the miRNA targets related to ATP binding, cellular components, protein binding, RNA binding, DNA binding, and so on. KEGG database was used for pathway analysis. Eleven pathways were identified in both HCHD and ECHD groups. Furthermore, 13 and 3 pathways were only identified in HCHD or ECHD group, respectively. And then, miRNA-gene regulatory networks were constructed to study the relationship between differentially expressed miRNAs and genes. This suggested that hsa-let-7c-5p and hsa-miR-24-3p might have the most important function for hyperglycemia in coronary heart disease patients.

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

Objective

to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International.

Method

an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015.

Results

altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia.

Conclusions

risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.