{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:17:34Z","timestamp":1789755454223,"version":"4.0.1"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify associations between short-term glycemic variability (GV) metrics and multidimensional adverse outcomes in critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, EMBASE, and Web of Science from inception to August 16, 2025. We included observational studies of adult ICU patients reporting associations between short-term GV and adverse outcomes. Random-effects models were used for all meta-analyses. Where feasible, effect estimates were standardized to a relative risk (RR) comparing the highest versus lowest quartiles of GV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 36 studies (123,911 patients), and 25 were meta-analyzed. ICU mortality was associated with standard deviation (SD; RR\u202f=\u202f2.29, 95% CI 1.71\u20133.07) and mean absolute glucose change (MAG; RR\u202f=\u202f2.24, 95% CI 1.19\u20134.23). Hospital mortality was associated with coefficient of variation (CV, RR\u202f=\u202f1.39, 95% CI 1.05\u20131.85) and SD (RR\u202f=\u202f2.26, 95% CI 1.19\u20134.30). 28\/30-day mortality was associated with CV (RR\u202f=\u202f1.34, 95% CI 1.10\u20131.63) and mean amplitude of glycemic excursions (MAGE; RR\u202f=\u202f2.05, 95% CI 1.52\u20132.77), and MAGE also predicted 90-day mortality (RR\u202f=\u202f2.90, 95% CI 1.96\u20134.30). Furthermore, each unit increase in SD predicted higher infection risk (OR\u202f=\u202f1.02, 95% CI 1.01\u20131.04) but not neurological adverse events (OR\u202f=\u202f1.23, 95% CI 0.91\u20131.66).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Short-term GV is a robust predictor of mortality across different follow-up windows and clinical settings, as well as infection-related outcomes. The current findings support using short-term GV as a key prognostic marker to complement mean glucose in intensive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD420251114266<\/jats:ext-link>\n                      , identifier PROSPERO (CRD420251114266).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1808757","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:28:09Z","timestamp":1780979289000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Short-term glycemic variability and the risk of adverse ICU outcomes in critically ill patients: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhongyi","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzheng","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Nursing, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjing","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cen","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Nursing, Suzhou Hospital Affiliated to Nanjing Medical University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e2562","DOI":"10.1097\/ccm.0000000000006884","article-title":"Critical illness-associated hyperglycemia and new-onset diabetes: a retrospective cohort study","volume":"53","author":"Soltani","year":"2025","journal-title":"Crit Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1186\/s13054-022-04004-1","article-title":"Impact of prolonged requirement for insulin on 90-day mortality in critically ill patients without previous diabetic treatments: a post hoc analysis of the Controling randomized control trial","volume":"26","author":"Thouy","year":"2022","journal-title":"Crit Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"10681","DOI":"10.1523\/jneurosci.23-33-10681.2003","article-title":"Hypoglycemic neuronal death and cognitive impairment are 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