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LETTERS TO THE EDITOR

Response to comment on article “Association between stress hyperglycemia and inhospital complications”

Gerardo Galindo-García,^a María Eugenia Galván-Plata,^b Haiko Nellen-Hummel,^c Eduardo Almeida-Gutiérrez^b

^aServicio de Medicina Interna, Hospital General Regional 2, Villa Coapa

^bCoordinación de Investigación en Salud

^cJefatura del Servicio de Medicina Interna, Hospital de Especialidades, Centro Médico Nacional Siglo XXI

Instituto Mexicano del Seguro Social, Distrito Federal, México.

Communication with: Gerardo Galindo-García

Telephone: (55) 2217 9879

Email: gerardo3g2010@hotmail.com

We consider the definition of stress hyperglycemia used in the article "Association between stress hyperglycemia and in-hospital complications" appropriate since according Dungan et al.¹ two diagnostic categories of stress hyperglycemia are proposed: in-hospital hyperglycemia according to the ADA definition (glucose level of 6.9 mmol/L or higher after fasting or a random glucose level of over 11.1 mmol / L without previous evidence of diabetes) and preexisting diabetes with poor glycemic control, so the term "stress hyperglycemia" is applicable in both cases. Moreover, it is correct to use “in-hospital hyperglycemia" or "stress hyperglycemia" since according to the consensus definition of the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologist (AACE) both terms refer to any concentration of serum glucose greater than 140 mg/dL.²

We agree with the editorial comment that "there is a significant association between hyperglycemia and adjusted mortality in unstable angina, acute myocardial infarction, congestive heart failure, arrhythmias, ischemic or hemorrhagic cerebrovascular disease, gastrointestinal bleeding, acute kidney injury, pneumonia, pulmonary embolism and sepsis”, considerations that were already mentioned in the introduction of our article.³

References

1. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycaemia. Lancet 2009;373(9677):1798–1807.
2. McDonnell ME, Umpierrez GE. Insulin therapy for the management of hyperglycemia in hospitalized patients. Endocrinol Metab Clin North Am 2012;41(1):175–201.
3. Galindo-García G, Galván-Plata ME, Nellen-Hummel H, Almeida-Gutiérrez E. Asociación entre hiperglucemia de estrés y complicaciones intrahospitalarias. Rev Med Inst Mex Seguro Soc 2015;53 (1):6-12.

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