Insulin Linked to Lower Mortality in Non-Diabetic Sepsis Patients

Sepsis, a life-threatening organ dysfunction caused by a dysregulated host response to infection, remains a leading cause of death in critically ill patients. While hyperglycemia (high blood sugar) is common in sepsis and often managed with insulin, its direct impact on patient outcomes, especially in those without pre-existing diabetes, is not fully understood. This study addresses the crucial question of whether insulin administration is associated with reduced 28-day mortality in non-diabetic sepsis patients.

The analysis revealed a significant association between insulin administration and improved survival outcomes. Patients who received insulin had a substantially lower 28-day mortality rate compared to the matched control group. Specifically, the insulin-treated group showed a mortality rate of 22.5%, whereas the non-insulin group had a rate of 30.1%, representing a 7.6 percentage point difference. After adjusting for all covariates, insulin administration was independently associated with a 28% reduction in the risk of 28-day mortality (Hazard Ratio (HR) 0.72, 95% CI 0.65-0.80, p<0.001). Subgroup analyses further indicated that patients with higher initial APACHE II scores (a severity-of-illness score) benefited most from insulin therapy, exhibiting an even greater 35% reduction in mortality. > The single most important finding was that insulin administration was associated with a significant 28% reduction in 28-day mortality in non-diabetic sepsis patients.