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Clinical data for admission glucose, glycemic gap and in-hospital death in 425 diabetic patients hospitalized because of AHF were collected retrospectively. Glycemic gap was calculated as the A1c-derived average glucose subtracted from the admission plasma glucose level. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value for glycemic gap to predict all-cause mortality. Patients with glycemic gap levels &gt;43\u2009mg\/dL had higher rates of all-cause death (adjusted hazard ratio, 7.225, 95% confidence interval, 1.355\u201338.520) than those with glycemic gap levels \u226443\u2009mg\/dL. The B-type natriuretic peptide levels incorporated with glycemic gap could increase the predictive capacity for in-hospital mortality and increase the area under the ROC from 0.764 to 0.805 (net reclassification improvement\u2009=\u20099.9%, p\u2009&lt;\u20090.05). In conclusion, glycemic gap may be considered a useful parameter for predicting the disease severity and prognosis of patients with diabetes hospitalized for AHF.<\/jats:p>","DOI":"10.1038\/s41598-019-42666-0","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T10:08:13Z","timestamp":1555582093000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Elevated Glycemic Gap Predicts Acute Respiratory Failure and In-hospital Mortality in Acute Heart Failure Patients with Diabetes"],"prefix":"10.1038","volume":"9","author":[{"given":"Wen-I","family":"Liao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jen-Chun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Sheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Jen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Ching","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Jye","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Ming","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Hung","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,4,18]]},"reference":[{"key":"42666_CR1","unstructured":"Thomas, M. 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