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(Military News Agency reporter, Chou Li-Xing, Taipei, July 24th) A major breakthrough in the clinical research of “Pneumonia Severity Prediction of Diabetic Patients” was made by the Tri-Service General Hospital Research Team led by the Director of the Emergency Medicine Department. The research team had discovered a close correlation between “Blood Glucose Difference” indicator during the admission of the patients and the severity of the pneumonia. This discovery was acknowledged by the international medical journal, Medicine, and published in August last year.

The Tri-Service General Hospital indicated that, as pneumonia has become a common disease in emergency treatment, there are currently many prediction tools for measuring the severity of the pneumonia patients but most of the indicator tools in existence require the computation of laboratory data, vital signs, and physiological conditions to calculate a score for evaluating the condition of the pneumonia patient. However, these complicated calculations are not easily accessible in the frontlines of emergency treatment, resulting in difficulties of evaluating patient conditions.

The Tri-Service General Hospital expressed that, as many of the critical care patients are often found to have hyperglycemia symptoms which are due to the secretion of hormones affected by the acute physical pressure, hence numerous previous researches have attempted to identify the correlations between the blood glucose levels and severity of the pneumonia during the admission of diabetic patients with pneumonia. However, as of today, many of the researches have yet to reach a definite conclusion.

Physician Liao Wen-Yi from the Emergency Medicine Department made a daring assumption that, the reason for the failure to establish a connection between hyperglycemia and pneumonia severity could be attributed to the fact that the daily blood glucose control of the diabetic patients are not taken into account. As such, physician Liao designed a glycated hemoglobin (HbA1c) that can identify the three-month average plasma glucose concentration to calculate the average blood glucose levels of the patient in recent months (28.7 x HbA1c – 46.7) so as to obtain the “Blood Glucose Difference” by subtracting the average blood glucose levels from the blood glucose levels during admission. Finally, guided by the leadership of Director Tsai Shih-Hung, the medical team conducted a correlation analysis between the “Blood Glucose Difference” and pneumonia severity through the research on 203 patients with diabetes and pneumonia.

The Tri-Service General Hospital further expressed that, the research had discovered that the Blood Glucose Difference indicator shows a greater correlation with the treatment results of pneumonia patients than the high blood glucose and poor long-term glucose control indicators. In addition, a high Blood Glucose Difference (≧40mg/dl) will also show a high correlation with the severity of the pneumonia, especially for pneumonia patients with high Blood Glucose Difference who will be subject to higher chances of acute kidney failure, respiratory failure, septic shock, and hospitalization in ICU. Furthermore, the number of days in the ICU, use of respirators and number of hospitalization days will also be longer.

The Tri-Service General Hospital stressed that, as pneumonia has become one of the largest infectious cause of death in developing countries, hence the use of the clinical data of Blood Glucose Difference in emergency treatment will be most crucial for the evaluation of pneumonia patient severity and treatment results which will in turn influence the type of treatment adopted. Hopefully, this breakthrough will benefit the majority of the diabetes and pneumonia patients in emergency treatment.