Blood glucose level plays an inevitable role in maintaining the metabolic processes. India, being the diabetes capital, projects how worse is the health status of Indians owing to the unhealthy lifestyle practices. Usually, blood sugar will be of a concern among most of us, only when we have diabetes. The inordinate variations in the blood sugar in people without diabetes will be ignored even during clinic visits. As the prevalence of diabetes and the number of diagnosed cases is shooting up to a greater pace, the scenario needs more careful attention.

      A recent review entitled “Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization”, was recently published in ‘Diabetes and Metabolic Syndrome: Clinical Research and Reviews’. For over 100 years, physicians and nurses have measured the vital signs; temperature, pulse rate, blood pressure, and respiratory rate which represent objective measurements of the essential physiological functions of a human being and reached important management decisions. The significance of blood glucose level in all hospital admissions is essential in today’s health scenario which reports increased rates of morbidity and mortality even in people without diabetes. It is crucial for health care professionals to be aware of the fact that blood sugar level even when in high normal range, or in slightly high range, is an important determinant of morbidity and mortality, especially in hospitalized patients and hence consider the inclusion of blood glucose measurement during clinical examinations.

      Recent studies have reported that even a slight elevation of blood glucose may increase mortality in patients with COVID-19 which signifies the impact of blood sugar variations in people. Several studies pertaining to the effect of blood sugar variations report serious adverse outcomes. In the perspective of COVID-19 pandemic, it was reported that Fasting blood glucose ≥ 126 mg/dL was associated with 28-day mortality risk in COVID-19 patients. Similar research highlights the negative outcomes such as highest mortality with blood glucose levels <55 mg/dL and >200 mg/dL, increased risk of stroke and all-cause mortality in patients when status is shifted from Normal Fasting Glucose to Diabetes Fasting Glucose, Increased risk of Cardiovascular disease in individuals with highest post-challenge blood glucose in the midpoint range of 150–194 mg/dL, and increased mortality in critically ill patients with blood glucose <81 mg/dL. Studies also report subjects with prediabetes as compared to those without having higher chances of hyperglycemia during hospital admissions. The adverse effects of mild hyperglycemia and hypoglycemia in people without diabetes are also reported in an overwhelming number of cases.

      In the view of the findings on the various impacts of variations in blood glucose level, the authors opined that blood sugar should be considered as the fifth vital sign and must consider the strict inclusion of blood glucose measurement for all hospital admissions.

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