{
  "abstract": "Background/Objectives: The prognostic meaning of early glycemic variability in sepsis may depend on whether the patient has diabetes. We examined the association of pre-existing diabetes with in-hospital mortality and tested whether diabetes modifies the prognostic association of early glycemic variability estimated from routine glucose measurements. Methods: This study uses a single-center retrospective cohort of 10,832 adults with sepsis identified from discharge documentation at a Romanian tertiary hospital (2011–2024). Early glycemic variability was the coefficient of variation (CV) of glucose within 24 h of the first measurement, computable in 6450 patients (59.5%). Logistic models using diabetes-by-glycemic-parameter interactions were complemented by stratified, landmark and weighted analyses and by standardized absolute risks. Results: In-hospital mortality was 53.6%. Diabetes was associated with lower adjusted odds of death (odds ratio [OR] of 0.822; 95% confidence interval [CI] of 0.751–0.899), corresponding to a standardized mortality of 50.5% vs. 54.8% (risk difference, −4.3 percentage points); the difference was smaller among patients alive 24 h after the first measurement (−2.8 percentage points). Per 0.10 increase in CV-24 h, the OR for death was 1.137 (1.102–1.173) without and 1.034 (0.994–1.076) with diabetes (interaction p < 0.001); diabetes also modified the associations of mean glucose and hyperglycemia. The CV interaction persisted after weighting and among 24 h survivors but was attenuated when deaths within 48–72 h were excluded; CV added little to the discrimination. Conclusions: In this observational cohort, the same degree of early glycemic variability carried different prognostic meaning, mainly for short-term mortality, in patients with and without diabetes. Diabetes was associated with modestly lower observed mortality, which should not be read as a protective effect. These are prognostic associations, not independent effects, and they do not define glucose targets.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania",
    "Innovation and eHealth Center, Carol Davila University of Medicine and Pharmacy, 010451 Bucharest, Romania",
    "C.F.2 Clinical Hospital, 011464 Bucharest, Romania",
    "General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Florentina Mușat"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Octavian Andronic",
      "orcid": "0000-0002-9053-0018"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Alexandra Bolocan"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Alina Mihaela Dobre"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Daniel Ion"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Dan Nicolae Păduraru"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/24tp1vsrkc7t3.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218649",
  "fulltext_url": null,
  "id": "24tp1vsrkc7t3",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8649",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/24tp1vsrkc7t3.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T00:21:23Z",
      "native_id": "10.3390/jcm15218649",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8649"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Early Glycemic Variability from Routine Glucose Measurements, Diabetes Status, and In-Hospital Mortality in Sepsis: A 14-Year Retrospective Cohort Study",
  "title_text": "Early Glycemic Variability from Routine Glucose Measurements, Diabetes Status, and In-Hospital Mortality in Sepsis: A 14-Year Retrospective Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T00:23:02Z",
  "url": "https://research.draconitic.com/paper/24tp1vsrkc7t3",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}