***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We examined the prevalence of impaired glucose metabolism and its association with inflammation and insulin resistance ( IR ) in acute myocardial infa rct ion ( AMI ) patients without a previous diagnosis of diabetes . This prospect i ve study enrolled 52 AMI patients , and  75-g oral glucose tolerance testing was performed on 30 patients at discharge and again 3 months later . We also measured  serum adiponectin , high sensitive C-reactive protein , and IL-6  on both occasions . Data were compared with those of 30 type 2 diabetic patients without a history of AMI . Forty percent and 36.7 % of AMI patients had impaired glucose tolerance ( IGT ) at discharge and at 3 months , respectively . The corresponding proportions for newly diagnosed diabetes are 33.0 % and 30.0 % . At discharge , AMI patients with IGT or diabetes showed higher high sensitive C-reactive protein and IL-6 levels compared with AMI patients with normal glucose tolerance or control type 2 diabetic patients . Furthermore , AMI patients with IGT or diabetes exhibited higher IR and lower serum adiponectin levels than AMI patients with normal glucose tolerance at 3 months after discharge . Previously undiagnosed diabetes and IGT are common in Korean patients with AMI . These glycometabolic abnormalities are associated with inflammation , IR , and serum adiponectin levels Background A high prevalence of impaired glucose tolerance and unknown type 2-diabetes in patients with coronary heart disease and no previous diagnosis of diabetes have been reported . The aims of the present study were to investigate the prevalence of abnormal glucose regulation ( AGR ) 3 months after an acute ST-elevation myocardial infa rct ion ( STEMI ) in patients without known glucometabolic disturbance , to evaluate the reliability of a 75-g oral glucose tolerance test ( OGTT ) performed very early after an acute STEMI to predict the presence of AGR at 3 months , and to study other potential predictors measured in-hospital for AGR at 3 months . Methods This was an observational cohort study prospect ively enrolling 224 STEMI patients treated with primary PCI .  An OGTT was performed very early after an acute STEMI and was repeated in 200 patients after 3 months . We summarised the exact agreement observed , and assessed the observed reproducibility of the OGTTs performed in-hospital and at follow up . The patients were classified into glucometabolic categories defined according to the World Health Organisation criteria . AGR was defined as the sum of impaired fasting glucose , impaired glucose tolerance and type 2-diabetes . Results The prevalence of AGR at three months was 24.9 % ( 95 % CI 19.1 , 31.4 % ) , reduced from 46.9 % ( 95 % CI 40.2 , 53.6 ) when measured in-hospital . Only , 108 of 201 ( 54 % ) patients remained in the same glucometabolic category after a repeated OGTT . High levels of HbA1c and admission plasma glucose in-hospital significantly predicted AGR at 3 months ( p < 0.001 , p = 0.040 , respectively ) , and fasting plasma glucose was predictive when patients with large myocardial infa rct ion were excluded ( p < 0.001 ) . Conclusion The prevalence of AGR in STEMI patients was lower than expected . HbA1c , admission plasma glucose and fasting plasma glucose measured in-hospital seem to be useful as early markers of longst and ing glucometabolic disturbance . An OGTT performed very early after a STEMI did not provide reliable information on long-term glucometabolic state and should probably not be recommended IMPORTANCE Physicians often perceive as futile intensive care interventions that prolong life without achieving an effect that the patient can appreciate as a benefit . The prevalence and cost of critical care perceived to be futile have not been prospect ively quantified . OBJECTIVE To quantify the prevalence and cost of treatment perceived to be futile in adult critical care . DESIGN , SETTING , AND PARTICIPANTS To develop a common definition of futile care , we convened a focus group of clinicians who care for critically ill patients . On a daily basis for 3 months , we surveyed critical care specialists in 5 intensive care units ( ICUs ) at an academic health care system to identify patients whom the physicians believed were receiving futile treatment .  Using a multivariate model , we identified patient and clinician characteristics associated with patients perceived to be receiving futile treatment . We estimated the total cost of futile treatment by summing the charges of each day of receiving perceived futile treatment and converting to costs . MAIN OUTCOME AND MEASURE Prevalence of patients perceived to be receiving futile treatment .  RESULTS During a 3-month period , there were 6916 assessment s by 36 critical care specialists of 1136 patients . Of these patients , 904 ( 80 % ) were never perceived to be receiving futile treatment , 98 ( 8.6 % ) were perceived as receiving probably futile treatment , 123 ( 11 % ) were perceived as receiving futile treatment , and 11 ( 1 % ) were perceived as receiving futile treatment only on the day they transitioned to palliative care . The patients with futile treatment assessment s received 464 days of treatment perceived to be futile in critical care ( range , 1 - 58 days ) , accounting for 6.7 % of all assessed patient days in the 5 ICUs studied . Eighty-four of the 123 patients perceived as receiving futile treatment died before hospital discharge and 20 within 6 months of ICU care ( 6-month mortality rate of 85 % ) , with survivors remaining in severely compromised health states . The cost of futile treatment in critical care was estimated at $ 2.6 million . CONCLUSIONS AND RELEVANCE In 1 health system , treatment in critical care that is perceived to be futile is common and the cost is substantial OBJECTIVE Our goal was to determine the association between r and om admission hyperglycemia and new diagnosis of diabetes after discharge in patients hospitalized with pneumonia . METHODS Clinical data , including the Pneumonia Severity Index , were prospect ively collected on all 2124 patients without diabetes admitted with pneumonia to 6 hospitals in Edmonton , Alberta , Canada . Admission glucose was classified as : normal ( 4.0 - 6.0 mmol/L , reference group ) versus mild ( 6.1 - 7.7 mmol/L ) , moderate ( 7.8 - 11.0 mmol/L ) , and severe ( 11.1 - 20.0 mmol/L ) stress hyperglycemia . New diagnosis of diabetes over 5 years was ascertained using well-vali date d criteria within linked administrative data bases . Multivariable Cox models were used , and sensitivity , specificity , and likelihood ratios were calculated . RESULTS Mean age was 68 years ; 1091 ( 51 % ) were male , and 1418 ( 67 % ) had stress hyperglycemia . Over 5 years , 194 ( 14 % ) with stress hyperglycemia were diagnosed with diabetes . Compared with the 45 of 706 ( 6 % ) incidences of diabetes in normal glycemia patients ( 4.0 - 6.0 mmol/L ) , a strong grade d increase in risk of new diabetes existed with increasing hyperglycemia : mild ( 59 of 841 [ 7 % ] ; adjusted hazard ratio [ aHR ] 1.09 ; 95 % confidence interval [ CI ] , 0.74 - 1.61 ) versus moderate ( 86 of 473 [ 18 % ] ; aHR 2.99 ; 95 % CI , 2.07 - 4.31 ) versus severe ( 49 of 104 [ 47 % ] ; aHR 11.43 ; 95 % CI , 7.50 - 17.42 ) . Among moderate-to-severe hyperglycemia ( ≥7.8 mmol/L ) patients , the sensitivity , specificity , and positive and negative likelihood ratios for new diabetes were 57 % , 77 % , 2.1 , and 0.6 , respectively , with a number-needed-to-evaluate of 5 to detect one new case of diabetes . CONCLUSION Moderate-to-severe r and om hyperglycemia in pneumonia patients admitted to the hospital is strongly associated with new diagnosis of diabetes . Opportunistic evaluation for diabetes may be warranted in this group BACKGROUND diabetes mellitus not only increases the risk of ischaemic stroke two- to four-fold but also adversely inXuences prognosis . The prevalence of recognised diabetes mellitus in acute stroke patients is between 8 and 20 % , but between 6 and 42 % of patients may have undiagnosed diabetes mellitus before presentation . Post-stroke hyperglycaemia is frequent and of limited diagnostic value and the oral glucose tolerance test assumes that the patient is clinical ly stable and eating normally . There is a need for a simple and reliable method to predict new diabetes mellitus in acute stroke patients . OBJECTIVES to determine the prevalence of unrecognised diabetes mellitus and impaired glucose tolerance on hospital admission and 12 weeks later in acute stroke patients with post-stroke hyperglycaemia > or = 6.1 mmol/l . To measure the accuracy of hyperglycaemia and elevated glycosylated haemoglobin concentration in predicting the presence of unrecognised diabetes mellitus at 12 weeks . DESIGN acute ( < 24 hours ) stroke patients ( cerebral infa rct ion and primary intracerebral haemorrhage ) with admission hyperglycaemia between 6.0 and 17 mmol/l and without a previous history of insulin-treated diabetes mellitus who were r and omised into the Glucose Insulin in Stroke Trial between October 1997 and May 1999 were studied . The Glucose Insulin in Stroke Trial is a r and omised controlled trial investigating the benefits of maintaining euglycaemia in acute stroke patients with mild to moderate hyperglycaemia . At 12 weeks , survivors underwent a 75 g oral glucose tolerance test . The positive predictive value and negative predictive value of admission plasma glucose > or = 6.1 mmol/l and elevated glycosylated haemoglobin concentration in predicting the presence of diabetes mellitus were used to estimate the prevalence of unrecognised diabetes mellitus in a consecutive series of 582 acute stroke admissions . RESULTS 582 consecutive acute stroke patients were assessed for eligibility for the Glucose Insulin Stroke Trial , of whom 83 ( 14 % ) had recognised diabetes mellitus . One hundred and forty-two patients were r and omised and 62 underwent a 3-month oral glucose tolerance test , of whom 26 ( 42 % ) had normal glucose tolerance , 23 ( 37 % ) had impaired glucose tolerance and 13 ( 21 % ) had diabetes mellitus . Admission plasma glucose > or = 6.1 mmol/l and glycosylated haemoglobin > or = 6.2 % predicted the presence of previously unrecognised diabetes mellitus at 12 weeks with a positive predictive value of 80 % and negative predictive value of 96 % . The estimated prevalence of unrecognised diabetes mellitus in the total series of acute stroke admissions was 16 - 24 % . CONCLUSIONS one-third of all acute stroke patients may have diabetes mellitus . For patients presenting with post-stroke hyperglycaemia , impaired glucose tolerance or diabetes mellitus is present in two-thirds of survivors at 12 weeks . Admission plasma glucose  > or = 6.1 mmol/l combined with glycosylated haemoglobin > or = 6.2 % are good predictors of the presence of diabetes mellitus following stroke BACKGROUND Impaired motor and hormonal gastrointestinal functions have been implicated in the pathogenesis of acute pancreatitis . The aim of the present study was to investigate the predictive value of the Gastroparesis Cardinal Symptom Index and serum ghrelin in the development of clinical ly meaningful outcomes in patients with acute pancreatitis . METHODS This was a prospect i ve clinical study . The Gastroparesis Cardinal Symptom Index and serum ghrelin were measured for 48 h after hospitalization . Univariate and multivariate logistic regression analyses were conducted . RESULTS The Gastroparesis Cardinal Symptom Index total score alone on day 2 was a significant predictor of oral feeding intolerance in both unadjusted ( odds ratio 1.21 ( 1.01 - 1.46 ) , P = 0.04 ) and adjusted ( odds ratio 1.30 ( 1.01 - 1.69 ) , P = 0.05 ) analyses . Adding ghrelin to Gastroparesis Cardinal Symptom Index further improved prediction in both unadjusted ( odds ratio 1.26 ( 1.02 - 1.56 ) , P = 0.03 ) and adjusted ( odds ratio 1.53 ( 1.00 - 2.35 ) , P =  
    Output:
    
The prevalence of new‐onset diabetes was not influenced by disease setting , follow‐up duration , or study design .
In summary , this study found stepwise growth in the prevalence of new‐onset diabetes with increasing in‐hospital glucose concentration .