Normoglycemia in Nondiabetic African Americans hospitalized with heart failure

Marshall S. Shook, Haris Zafarullah, Maeda D. Nelson, Syamal Bhattacharya, Richard C. Davis, Kevin P. Newman, Karl Weber

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: In nondiabetic patients hospitalized with multiorgan failure, neurohormonal activation can lead to stress-induced hyperglycemia (>140 mg/dL), as could Mg and Zn deficiencies. However, it is currently uncertain whether nondiabetic African Americans (AA) hospitalized with either chronic, decompensated biventricular failure (DecompHF) having hepatic and splanchnic congestion, ionized hypomagnesemia and hypozincemia, or acute left heart failure (LHF) would exhibit hyperglycemia at admission. METHODS: We retrospectively examined admission serum glucose in 77 AA patients without a history of diabetes, who were hospitalized with heart failure. This examination included 41 patients admitted during a 4-month period with chronic DecompHF and whose clinical presentation included findings of expanded intra- and extravascular volumes, together with echocardiographic evidence of marked tricuspid regurgitation and distended inferior vena cava, without respiratory variation. These patients were compared with 14 nondiabetic patients hospitalized during the same time period with acute LHF. We also studied admission serum glucose in 22 patients who were admitted with DecompHF having documented hypomagnesemia and hypozincemia. RESULTS: Admission serum glucose (mean ± standard error of mean) in patients with chronic DecompHF was 105.41 ± 4.08 mg/dL and was modestly elevated (140-160 mg/dL) in 3 patients. In those with acute LHF, glucose was 94.86 ± 3.96 mg/dL and did not exceed 140 mg/dL in any patient. Glucose (103.2 ± 4.3 mg/dL) was not elevated in patients having chronic DecompHF and reduced ionized Mg and serum Zn (0.44 ± 0.01 mmol/L and 69.6 ± 3.2 μg/dL, respectively). CONCLUSIONS: Hyperglycemia at admission was infrequent in nondiabetic AA patients hospitalized with either acute LHF or chronic DecompHF, which may have also included hypomagnesemia and hypozincemia. This calls into question the need for intensive insulin therapy in these patients.

Original languageEnglish (US)
Pages (from-to)255-258
Number of pages4
JournalAmerican Journal of the Medical Sciences
Volume338
Issue number4
DOIs
StatePublished - Jan 1 2009

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African Americans
Heart Failure
Glucose
Hyperglycemia
Serum
Tricuspid Valve Insufficiency
Viscera
Inferior Vena Cava
Insulin

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Normoglycemia in Nondiabetic African Americans hospitalized with heart failure. / Shook, Marshall S.; Zafarullah, Haris; Nelson, Maeda D.; Bhattacharya, Syamal; Davis, Richard C.; Newman, Kevin P.; Weber, Karl.

In: American Journal of the Medical Sciences, Vol. 338, No. 4, 01.01.2009, p. 255-258.

Research output: Contribution to journalArticle

Shook, Marshall S. ; Zafarullah, Haris ; Nelson, Maeda D. ; Bhattacharya, Syamal ; Davis, Richard C. ; Newman, Kevin P. ; Weber, Karl. / Normoglycemia in Nondiabetic African Americans hospitalized with heart failure. In: American Journal of the Medical Sciences. 2009 ; Vol. 338, No. 4. pp. 255-258.
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abstract = "BACKGROUND: In nondiabetic patients hospitalized with multiorgan failure, neurohormonal activation can lead to stress-induced hyperglycemia (>140 mg/dL), as could Mg and Zn deficiencies. However, it is currently uncertain whether nondiabetic African Americans (AA) hospitalized with either chronic, decompensated biventricular failure (DecompHF) having hepatic and splanchnic congestion, ionized hypomagnesemia and hypozincemia, or acute left heart failure (LHF) would exhibit hyperglycemia at admission. METHODS: We retrospectively examined admission serum glucose in 77 AA patients without a history of diabetes, who were hospitalized with heart failure. This examination included 41 patients admitted during a 4-month period with chronic DecompHF and whose clinical presentation included findings of expanded intra- and extravascular volumes, together with echocardiographic evidence of marked tricuspid regurgitation and distended inferior vena cava, without respiratory variation. These patients were compared with 14 nondiabetic patients hospitalized during the same time period with acute LHF. We also studied admission serum glucose in 22 patients who were admitted with DecompHF having documented hypomagnesemia and hypozincemia. RESULTS: Admission serum glucose (mean ± standard error of mean) in patients with chronic DecompHF was 105.41 ± 4.08 mg/dL and was modestly elevated (140-160 mg/dL) in 3 patients. In those with acute LHF, glucose was 94.86 ± 3.96 mg/dL and did not exceed 140 mg/dL in any patient. Glucose (103.2 ± 4.3 mg/dL) was not elevated in patients having chronic DecompHF and reduced ionized Mg and serum Zn (0.44 ± 0.01 mmol/L and 69.6 ± 3.2 μg/dL, respectively). CONCLUSIONS: Hyperglycemia at admission was infrequent in nondiabetic AA patients hospitalized with either acute LHF or chronic DecompHF, which may have also included hypomagnesemia and hypozincemia. This calls into question the need for intensive insulin therapy in these patients.",
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AU - Shook, Marshall S.

AU - Zafarullah, Haris

AU - Nelson, Maeda D.

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AU - Davis, Richard C.

AU - Newman, Kevin P.

AU - Weber, Karl

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N2 - BACKGROUND: In nondiabetic patients hospitalized with multiorgan failure, neurohormonal activation can lead to stress-induced hyperglycemia (>140 mg/dL), as could Mg and Zn deficiencies. However, it is currently uncertain whether nondiabetic African Americans (AA) hospitalized with either chronic, decompensated biventricular failure (DecompHF) having hepatic and splanchnic congestion, ionized hypomagnesemia and hypozincemia, or acute left heart failure (LHF) would exhibit hyperglycemia at admission. METHODS: We retrospectively examined admission serum glucose in 77 AA patients without a history of diabetes, who were hospitalized with heart failure. This examination included 41 patients admitted during a 4-month period with chronic DecompHF and whose clinical presentation included findings of expanded intra- and extravascular volumes, together with echocardiographic evidence of marked tricuspid regurgitation and distended inferior vena cava, without respiratory variation. These patients were compared with 14 nondiabetic patients hospitalized during the same time period with acute LHF. We also studied admission serum glucose in 22 patients who were admitted with DecompHF having documented hypomagnesemia and hypozincemia. RESULTS: Admission serum glucose (mean ± standard error of mean) in patients with chronic DecompHF was 105.41 ± 4.08 mg/dL and was modestly elevated (140-160 mg/dL) in 3 patients. In those with acute LHF, glucose was 94.86 ± 3.96 mg/dL and did not exceed 140 mg/dL in any patient. Glucose (103.2 ± 4.3 mg/dL) was not elevated in patients having chronic DecompHF and reduced ionized Mg and serum Zn (0.44 ± 0.01 mmol/L and 69.6 ± 3.2 μg/dL, respectively). CONCLUSIONS: Hyperglycemia at admission was infrequent in nondiabetic AA patients hospitalized with either acute LHF or chronic DecompHF, which may have also included hypomagnesemia and hypozincemia. This calls into question the need for intensive insulin therapy in these patients.

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