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The following is a summary of “Diabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials,” published in the October 2024 issue of Critical Care by Long et al. 

Diabetes mellitus has been linked to more challenging tracheal intubation in the operating room, but its impact on intubation for critically ill adults has not yet been studied. 

Researchers conducted a retrospective study to assess whether people with diabetes have longer intubation times after anesthesia in patients with critical illness.

They analyzed data from 5 randomized trials from the Pragmatic Critical Care Research Group, including critically ill adults undergoing tracheal intubation in emergency departments (EDs) or intensive care units (ICUs) at 11 U.S. centers. The study focused on factors like pre-intubation checklists, fluid bolus administration, bag-mask ventilation, and bougie vs. stylet intubation. 

The results showed that 2,654 patients were included, with 24% (n=638) having diabetes. The average time from anesthesia induction to intubation was 169 seconds (sd=137). Complications occurred in 37.9% (1007) of the patients during intubation. Diabetes did not impact intubation time compared to non-diabetes (-4.4s; 95% CI: -17.2 to 8.3s, P=0.50), first-attempt success rates (85.6% vs. 84.3%, P=0.46), or complication rates (39.8% vs. 37.4%, P=0.52). 

Investigators concluded that diabetes did not affect intubation time, first-attempt success, or complication rates in patients with critical illness undergoing tracheal intubation, suggesting no independent impact of diabetes on these outcomes. 

Source: journals.lww.com/ccmjournal/abstract/9900/diabetes_mellitus_is_not_a_risk_factor_for.392.aspx