{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:47:09Z","timestamp":1790657229652,"version":"4.1.0"},"reference-count":51,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine, Pharmacy, Science and Technology \u201cGeorge Emil Palade\u201d of T\u00eergu Mure\u0219","award":["164\/13\/ 10.01.2023"],"award-info":[{"award-number":["164\/13\/ 10.01.2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Diabetic ketoacidosis (DKA) represents the most prevalent hyperglycemic emergency and poses a significant life-threatening metabolic risk for individuals with diabetes. The present study examines the predictive role of the leukocyte glucose index (LGI) values at baseline in diagnosing the severity of DKA and their correlation with the presence of diabetes-related microvascular complications. Materials and Methods: A retrospective observational study was conducted involving a total of 94 patients who had previously confirmed diagnoses of either Type I or Type II diabetes mellitus and presented with ketoacidosis upon emergency admission to the Department of Diabetology, Nutrition, and Metabolic Disease. Demographic information, values of arterial systolic and diastolic pressure, known duration and type of diabetes, severity of ketoacidosis, routine laboratory results, and blood gas analyses were retrieved from the hospital\u2019s electronic database. Results: Higher diastolic blood pressure (DBP) values were observed in both mild (p = 0.021) and severe DKA (p = 0.035) compared to moderate DKA. When examining laboratory data, elevated white blood cell (WBC) counts were observed in severe DKA when compared to mild DKA (p = 0.009), as well as increased neutrophil counts in both moderate (p = 0.038) and severe (p = 0.011) DKA relative to mild DKA. Furthermore, patients with severe DKA exhibited lower values of venous blood pH, partial pressure of carbon dioxide (pvCO2), base excess (BE), and bicarbonate than the other groups (all p &lt; 0.05), alongside higher levels of lactate, anion gap, and LGI (all p &lt; 0.05). Regarding the parameters of arterial blood gas, we identified a negative correlation between LGI values and venous blood pH (r = \u22120.383, p &lt; 0.001), serum bicarbonate (r = \u22120.352, p &lt; 0.001), pCO2 (r = \u22120.271, p = 0.009), and BE (r = \u22120.330, p &lt; 0.001). At univariate analysis, elevated LGI values are associated with the severity of DKA (OR: 1.87, p = 0.016) and diabetes-related microvascular complications (OR: 2.16, p = 0.010). Conclusions: The positive correlation between LGI and DKA severity and between LGI and diabetes microvascular complications highlights the potential utility of LGI as a predictive marker, facilitating early risk stratification and clinical decision-making.<\/jats:p>","DOI":"10.3390\/medicina61050898","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T06:10:44Z","timestamp":1747289444000},"page":"898","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Elevated Leukocyte Glucose Index (LGI) Is Associated with Diabetic Ketoacidosis (DKA) Severity and Presence of Microvascular Complications"],"prefix":"10.3390","volume":"61","author":[{"given":"Mircea C\u0103t\u0103lin","family":"Co\u0219arc\u0103","sequence":"first","affiliation":[{"name":"Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Maria","family":"Tilinca","sequence":"additional","affiliation":[{"name":"Clinic of Epidemiology, Mures County Emergency Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2020-8182","authenticated-orcid":false,"given":"Nicolae Alexandru","family":"Laz\u0103r","sequence":"additional","affiliation":[{"name":"Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9350-7864","authenticated-orcid":false,"given":"Suzana Vasilica","family":"\u0218incaru","sequence":"additional","affiliation":[{"name":"Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Corneliu","family":"Bandici","sequence":"additional","affiliation":[{"name":"Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3474-4011","authenticated-orcid":false,"given":"Cosmin","family":"Cara\u0219ca","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2173-4740","authenticated-orcid":false,"given":"R\u00e1duly","family":"Gerg\u0151","sequence":"additional","affiliation":[{"name":"Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Vasile","family":"Mure\u0219an","sequence":"additional","affiliation":[{"name":"Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania"},{"name":"Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Cornelia","family":"Tilinca","sequence":"additional","affiliation":[{"name":"Discipline of Internal Medicine, Department ME2, Faculty of Medicine, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101418","DOI":"10.1016\/j.disamonth.2022.101418","article-title":"Diabetic Ketoacidosis","volume":"69","author":"Calimag","year":"2023","journal-title":"Dis. Mon."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s41572-020-0165-1","article-title":"Diabetic Ketoacidosis","volume":"6","author":"Dhatariya","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2024). Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2024. Diabetes Care, 47, S158\u2013S178.","DOI":"10.2337\/dc24-S009"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/1753-0407.12297","article-title":"Prevalence of Diabetes Mellitus and Prediabetes in the Adult Romanian Population: PREDATORR Study","volume":"8","author":"Mota","year":"2016","journal-title":"J. Diabetes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1007\/s00125-024-06183-8","article-title":"Hyperglycaemic Crises in Adults with Diabetes: A Consensus Report","volume":"67","author":"Umpierrez","year":"2024","journal-title":"Diabetologia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1001\/archinte.164.17.1925","article-title":"Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes Mellitus: Clinical and Biochemical Differences","volume":"164","author":"Newton","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.diabres.2017.04.004","article-title":"Incidence of Diabetic Ketoacidosis among Patients with Type 2 Diabetes Mellitus Treated with SGLT2 Inhibitors and Other Antihyperglycemic Agents","volume":"128","author":"Wang","year":"2017","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.2337\/dc17-1583","article-title":"Trends in Hospital Admission for Diabetic Ketoacidosis in Adults with Type 1 and Type 2 Diabetes in England, 1998\u20132013: A Retrospective Cohort Study","volume":"41","author":"Zhong","year":"2018","journal-title":"Diabetes Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"239","DOI":"10.37358\/RC.20.1.7839","article-title":"Evaluation of Metabolic and Hydroelectrolytic Disturbances in Patients Diagnosed with Diabetic Ketoacidosis","volume":"71","author":"Tilinca","year":"2020","journal-title":"Rev. Chim."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Scutca, A.-C., Nicoar\u0103, D.-M., Mang, N., Jug\u0103naru, I., Brad, G.-F., and M\u0103rginean, O. (2023). Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11112976"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S1521-6616(03)00144-X","article-title":"Cytokine Response to Diabetic Ketoacidosis and Its Treatment","volume":"108","author":"Hoffman","year":"2003","journal-title":"Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.2337\/diabetes.53.8.2079","article-title":"Proinflammatory Cytokines, Markers of Cardiovascular Risks, Oxidative Stress, and Lipid Peroxidation in Patients with Hyperglycemic Crises","volume":"53","author":"Stentz","year":"2004","journal-title":"Diabetes"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Aslan Sirakaya, H., Sipahioglu, H., Cetinkaya, A., and Aydin, K. (2025). Relationship Between Inflammatory Markers (IL-6, Neutrophil\u2013Lymphocyte Ratio, and C-Reactive Protein-Albumin Ratio) and Diabetic Ketoacidosis Severity: Correlation with Clinical Outcomes. Medicina, 61.","DOI":"10.3390\/medicina61020321"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3865","DOI":"10.1097\/MS9.0000000000002185","article-title":"Association of the Systemic Immune-Inflammation Index (SII) and Severity of Diabetic Ketoacidosis in Patients with Type 1 Diabetes Mellitus: A Retrospective Cohort Study","volume":"86","author":"Aon","year":"2024","journal-title":"Ann. Med. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"58","DOI":"10.2478\/amma-2024-0013","article-title":"Prognostic Value of Leukocyte-Glycemic Index in Long-Term Evolution of Diabetic Patients with Peripheral Arterial Disease Following Endovascular Treatment","volume":"70","author":"Arbanasi","year":"2024","journal-title":"Acta Marisiensis-Ser. Medica"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1191\/1358863x05vm617oa","article-title":"Inflammatory Markers and IL-6 Polymorphism in Peripheral Arterial Disease with and without Diabetes Mellitus","volume":"10","author":"Danielsson","year":"2005","journal-title":"Vasc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lin, H.-Y., Zhang, X.-J., Liu, Y.-M., Geng, L.-Y., Guan, L.-Y., and Li, X.-H. (2021). Comparison of the Triglyceride Glucose Index and Blood Leukocyte Indices as Predictors of Metabolic Syndrome in Healthy Chinese Population. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-89494-9"},{"key":"ref_18","first-page":"e947156","article-title":"Leukoglycemic Index and Its Prognostic Implications in Diabetic and Nondiabetic Patients with Acute Pulmonary Embolism","volume":"31","author":"Aslan","year":"2025","journal-title":"Med. Sci. Monit."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.2147\/DMSO.S356461","article-title":"Prognostic Value of the Leuko-Glycemic Index in Acute Myocardial Infarction Patients with or without Diabetes","volume":"15","author":"Qi","year":"2022","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.29271\/jcpsp.2022.12.1519","article-title":"Predicting the Severity of Coronary Artery Disease: Can the Leukocyte Glucose Index Be Used?","volume":"32","author":"Kilic","year":"2022","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"484","DOI":"10.21470\/1678-9741-2020-0349","article-title":"Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting","volume":"36","author":"Seoane","year":"2021","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ramos-Hern\u00e1ndez, W.M., Soto, L.F., del Rosario-Trinidad, M., Farfan-Morales, C.N., de Jes\u00fas-Gonz\u00e1lez, L.A., Mart\u00ednez-Mier, G., Osuna-Ramos, J.F., Bastida-Gonz\u00e1lez, F., Bernal-Dolores, V., and del \u00c1ngel, R.M. (2022). Leukocyte Glucose Index as a Novel Biomarker for COVID-19 Severity. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-18786-5"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101994","DOI":"10.1016\/j.toxrep.2025.101994","article-title":"The Role of the Leukocyte Glucose Index in Predicting Clinical Outcomes in Acute Methanol Toxicity","volume":"14","author":"Nafea","year":"2025","journal-title":"Toxicol. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4082\/kjfm.2018.39.1.42","article-title":"Association of Fasting Glucose Level with Neutrophil-Lymphocyte Ratio Compared to Leukocyte Count and Serum C-Reactive Protein","volume":"39","author":"Kim","year":"2018","journal-title":"Korean J. Fam. Med."},{"key":"ref_25","first-page":"e25","article-title":"Prognostic Value of the Leuko-Glycemic Index in Acute Myocardial Infarction; a Systematic Review and Meta-Analysis","volume":"11","author":"Sadeghi","year":"2023","journal-title":"Arch. Acad. Emerg. Med."},{"key":"ref_26","first-page":"e63","article-title":"Leuko-Glycemic Index in the Prognosis of Acute Myocardial Infarction; a Cohort Study on Coronary Angiography and Angioplasty Registry","volume":"11","author":"Sadeghi","year":"2023","journal-title":"Arch. Acad. Emerg. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.18621\/eurj.1342326","article-title":"Prognostic Value of the Leuko-Glycemic Index in Coronary Chronic Total Occlusion Patients","volume":"9","author":"Peker","year":"2023","journal-title":"Eur. Res. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.32322\/jhsm.1349575","article-title":"The Leuko-Glycemic Index Can Predict Multivessel Disease in the Elderly Acute Myocardial Infarction Population? A Retrospective Cohort Study","volume":"6","author":"Demir","year":"2023","journal-title":"J. Health Sci. Med.\/JHSM"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Charoenpiriya, A., Chailurkit, L., and Ongphiphadhanakul, B. (2022). Comparisons of Biochemical Parameters and Diabetic Ketoacidosis Severity in Adult Patients with Type 1 and Type 2 Diabetes. BMC Endocr. Disord., 22.","DOI":"10.1186\/s12902-021-00922-3"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ata, F., Khan, A.A., Khamees, I., Mohammed, B.Z.M., Barjas, H.H., Muthanna, B., Bashir, M., and Kartha, A. (2023). Differential Evolution of Diabetic Ketoacidosis in Adults with Pre-Existent versus Newly Diagnosed Type 1 and Type 2 Diabetes Mellitus. BMC Endocr. Disord., 23.","DOI":"10.1186\/s12902-023-01446-8"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Almazrouei, R., Siddiqua, A.R., Alnuaimi, M., Al-Shamsi, S., and Govender, R. (2022). Clinical and Biochemical Characteristics of Diabetic Ketoacidosis in Adults with Type 1 or Type 2 Diabetes at a Tertiary Hospital in the United Arab Emirates. Front. Clin. Diabetes Healthc., 3.","DOI":"10.3389\/fcdhc.2022.918253"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s00592-020-01538-0","article-title":"Multicentre Analysis of Hyperglycaemic Hyperosmolar State and Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes","volume":"57","author":"Tittel","year":"2020","journal-title":"Acta Diabetol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.jdiacomp.2016.06.023","article-title":"Distinct Clinical Characteristics and Therapeutic Modalities for Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes Mellitus","volume":"31","author":"Kamata","year":"2017","journal-title":"J. Diabetes Its Complicat."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Emil-Marian, A., Reka, K., Adrian, M., Septimiu, V., Eliza-Mihaela, A., and Eliza, R. (2022). Impact of COVID-19 Pandemic on Vascular Surgery Unit Activity in Central Romania. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.883935"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"102389","DOI":"10.1016\/j.dsx.2022.102389","article-title":"The Impact of COVID-19 on Diabetic Ketoacidosis Patients","volume":"16","author":"Khan","year":"2022","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Stoian, M., Andone, A., Boeriu, A., B\u00e2ndil\u0103, S.R., Dobru, D., Laszlo, S.\u0218., Cor\u0103u, D., Arb\u0103na\u0219i, E.M., Russu, E., and Stoian, A. (2024). COVID-19 and Clostridioides Difficile Coinfection Analysis in the Intensive Care Unit. Antibiotics, 13.","DOI":"10.3390\/antibiotics13040367"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1210\/clinem\/dgaa360","article-title":"Diabetic Ketoacidosis in COVID-19: Unique Concerns and Considerations","volume":"105","author":"Palermo","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Stoian, A., Bajko, Z., Stoian, M., Cioflinc, R.A., Niculescu, R., Arb\u0103na\u0219i, E.M., Russu, E., Botoncea, M., and B\u0103la\u0219a, R. (2023). The Occurrence of Acute Disseminated Encephalomyelitis in SARS-CoV-2 Infection\/Vaccination: Our Experience and a Systematic Review of the Literature. Vaccines, 11.","DOI":"10.3390\/vaccines11071225"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1111\/dom.15036","article-title":"COVID-19 Associated Ketosis and Diabetic Ketoacidosis: A Rapid Review","volume":"25","author":"Alamuri","year":"2023","journal-title":"Diabetes Obes. Metab."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mure\u0219an, A.V., Russu, E., Arb\u0103na\u0219i, E.M., Kaller, R., Hosu, I., Arb\u0103na\u0219i, E.M., and Void\u0103zan, S.T. (2022). Negative Impact of the COVID-19 Pandemic on Kidney Disease Management\u2014A Single-Center Experience in Romania. J. Clin. Med., 11.","DOI":"10.3390\/jcm11092452"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Halmaciu, I., Arb\u0103na\u0219i, E.M., Kaller, R., Mure\u0219an, A.V., Arb\u0103na\u0219i, E.M., Bacalbasa, N., Suciu, B.A., Cojocaru, I.I., Runcan, A.I., and Grosu, F. (2022). Chest CT Severity Score and Systemic Inflammatory Biomarkers as Predictors of the Need for Invasive Mechanical Ventilation and of COVID-19 Patients\u2019 Mortality. Diagnostics, 12.","DOI":"10.3390\/diagnostics12092089"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Arb\u0103na\u0219i, E.M., Halmaciu, I., Kaller, R., Mure\u0219an, A.V., Arb\u0103na\u0219i, E.M., Suciu, B.A., Co\u0219arc\u0103, C.M., Cojocaru, I.I., Melinte, R.M., and Russu, E. (2022). Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients. Diagnostics, 12.","DOI":"10.3390\/diagnostics12102379"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Mure\u0219an, A.V., H\u0103lmaciu, I., Arb\u0103na\u0219i, E.M., Kaller, R., Arb\u0103na\u0219i, E.M., Budi\u0219c\u0103, O.A., Melinte, R.M., Vunvulea, V., Filep, R.C., and M\u0103rginean, L. (2022). Prognostic Nutritional Index, Controlling Nutritional Status (CONUT) Score, and Inflammatory Biomarkers as Predictors of Deep Vein Thrombosis, Acute Pulmonary Embolism, and Mortality in COVID-19 Patients. Diagnostics, 12.","DOI":"10.3390\/diagnostics12112757"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Buicu, A.-L., Cernea, S., Benedek, I., Buicu, C.-F., and Benedek, T. (2021). Systemic Inflammation and COVID-19 Mortality in Patients with Major Noncommunicable Diseases: Chronic Coronary Syndromes, Diabetes and Obesity. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081545"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e3565","DOI":"10.1002\/dmrr.3565","article-title":"Inflammation and Vascular Dysfunction: The Negative Synergistic Combination of Diabetes and COVID-19","volume":"38","author":"Bolla","year":"2022","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ahmad, R., Narwaria, M., Singh, A., Kumar, S., and Haque, M. (2023). Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic Tools. Diagnosis, 13.","DOI":"10.3390\/diagnostics13142441"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"367","DOI":"10.2174\/1871530321666210924124336","article-title":"Hyperglycemia-Induced Immune System Disorders in Diabetes Mellitus and the Concept of Hyperglycemic Memory of Innate Immune Cells: A Perspective","volume":"22","author":"Lisco","year":"2022","journal-title":"Endocr. Metab. Immune Disord. Drug Targets"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Raya-Cano, E., Vaquero-Abell\u00e1n, M., Molina-Luque, R., Molina-Recio, G., Guzm\u00e1n-Garc\u00eda, J.M., Jim\u00e9nez-M\u00e9rida, R., and Romero-Salda\u00f1a, M. (2023). Association between Metabolic Syndrome and Leukocytes: Systematic Review and Meta-Analysis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12227044"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Mure\u0219an, A.V., Florea, E., Arb\u0103na\u0219i, E.-M., Bartus, R., Arb\u0103na\u0219i, E.-M., Ion, A.P., Cordo\u0219, B.A., Halatiu, V.B., Niculescu, R., and Stoian, A. (2024). Elevated Leukocyte Glucose Index Is Associated with Long-Term Arteriovenous Fistula Failure in Dialysis Patients. J. Clin. Med., 13.","DOI":"10.3390\/jcm13072037"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Pattharanitima, P., Thongprayoon, C., Kaewput, W., Qureshi, F., Qureshi, F., Petnak, T., Srivali, N., Gembillo, G., O\u2019Corragain, O.A., and Chesdachai, S. (2021). Machine Learning Prediction Models for Mortality in Intensive Care Unit Patients with Lactic Acidosis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215021"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/s41574-022-00690-7","article-title":"The Burden and Risks of Emerging Complications of Diabetes Mellitus","volume":"18","author":"Tomic","year":"2022","journal-title":"Nat. Rev. Endocrinol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/898\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:33:04Z","timestamp":1760031184000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/898"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,15]]},"references-count":51,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050898"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050898","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,15]]}}}