Stress Hyperglycemia Ratio and Glucose Variability in Critically Ill Patients

This prospective cohort study aims to evaluate the stress hyperglycemia ratio and glucose variability among critically ill patients admitted to the intensive care unit.

Inclusion Criteria: * Adult patients aged 18 years or older * Admitted to the ICU with expected stay of at least 24 hours * HbA1c and admission blood glucose obtainable within the first 24 hours * Written informed consent from the patient or legal guardian Exclusion Criteria: * \- Age less than 18 years * Death or ICU discharge within 24 hours of admission * Pregnancy * Diabetic ketoacidosis or hyperosmolar hyperglycemic state at presentation * Conditions that falsely alter HbA1c * Fewer than 3 glucose measurements in the first 24 hours * Terminal illness with palliative or do-not-resuscitate decision * Refusal of consent