Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan-Feb;15(1):221-227.
doi: 10.1016/j.dsx.2020.12.032. Epub 2021 Jan 2.

Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization

Jothydev Kesavadev  1 , Anoop Misra  2 , Banshi Saboo  3 , S R Aravind  4 , Akhtar Hussain  5 , Leszek Czupryniak  6 , Itamar Raz  7
Affiliations
Review

Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization

Jothydev Kesavadev et al. Diabetes Metab Syndr. 2021 Jan-Feb.

Abstract

Background and aims: The measurement of vital signs is an important part of clinical work up. Presently, measurement of blood glucose is a factor for concern mostly when treating individuals with diabetes. Significance of blood glucose measurement in prognosis of non-diabetic and hospitalized patients is not clear.

Methods: A systematic search of literature published in the Electronic databases, PubMed and Google Scholar was performed using following keywords; blood glucose, hospital admissions, critical illness, hospitalizations, cardiovascular disease (CVD), morbidity, and mortality. This literature search was largely restricted to non-diabetic individuals.

Results: Blood glucose level, even when in high normal range, or in slightly high range, is an important determinant of morbidity and mortality, especially in hospitalized patients. Further, even slight elevation of blood glucose may increase mortality in patients with COVID-19. Finally, blood glucose variability and hypoglycemia in critically ill individuals without diabetes causes excess in-hospital complications and mortality.

Conclusion: In view of these data, we emphasize the significance of blood glucose measurement in all patients admitted to the hospital regardless of presence of diabetes. We propose that blood glucose be included as the "fifth vital sign" for any hospitalized patient.

Keywords: Blood glucose; Cardiovascular disease; Glycemic variability; Hypoglycemia; Impaired glucose tolerance; Intensive insulin therapy.

PubMed Disclaimer

Comment in

References

    1. Elliott M., Coventry A. Critical care: the eight vital signs of patient monitoring. Br J Nurs. 2012;21:621–625. - PubMed
    1. Cooper R.J., Schriger D.L., Flaherty H.L., Lin E.J., Hubbell K.A. Effect of vital signs on triage decisions. Ann Emerg Med. 2002;39(3):223–232. - PubMed
    1. Lockwood C., Conroy-Hiller T., Page T. Vital signs. JBI Rep. 2004;2(6):207–230. - PubMed
    1. Bansal N. Prediabetes diagnosis and treatment: a review. World J Diabetes. 2015;6(2):296–303. - PMC - PubMed
    1. Tirosh A., Shai I., Tekes-Manova D., Israeli E., Pereg D., Shochat T. Normal fasting plasma glucose levels and type 2 diabetes in young men. N Engl J Med. 2005;353(14):1454–1462. - PubMed