© 2006 Diabetes UK. Diabetic Medicine, 23, 623–628 623 Abstract Aims To investigate the relationships between a known history of diabetes and ambient fasting plasma glucose (FPG) levels with death and morbidity rates in patients with severe acute respiratory syndrome (SARS). Methods In this retrospective analysis, the clinical and biochemical character- istics of 135 patients who had died from SARS, 385 survivors of SARS and 19 patients with non-SARS pneumonia were compared. Results All patients were treated according to a predefined protocol. Before steroid treatment, the mean FPG level was significantly higher in the SARS group (deceased vs. survivors vs. non-SARS pneumonia group: 9.7 ± 5.2 vs. 6.5 ± 3.0 vs. 5.1 ± 1.0 mmol / l, P < 0.01). In the SARS group, the percentage of patients with a known history of diabetes was significantly higher in the deceased patients than in the survivors (21.5% vs. 3.9%, P < 0.01). Among patients with no known history of diabetes and before commencement of steroid therapy, those who had hypoxaemia (SaO 2 < 93%) had higher FPG levels than those who did not have hypoxia in both the survivor (8.7 ± 4.9 vs. 6.3 ± 2.1 mmol / l, P < 0.001) and deceased (9.8 ± 4.8 vs. 7.2 ± 1.5 mmol / l, P < 0.001) groups. A known history of diabetes [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.4, 6.3; P = 0.005] and FPG ≥ 7.0 mmol / l before steroid treatment (OR 3.3, 95% CI 1.4, 7.7, P = 0.006) were independent predictors of death. During the course of the illness, FPG levels were negatively associated with SaO 2 (β = -0.682 ± 0.305, P = 0.025, general estimation equation model) in SARS patients. Survival analysis showed that FPG was independently associated with an increased hazard ratio (HR) of mortality (HR = 1.1, 95% CI 1.0, 1.1, P = 0.001) and hypoxia (HR = 1.1, 95% CI 1.0, 1.1, P = 0.002) after controlling for age and gender. Conclusions A known history of diabetes and ambient hyperglycaemia were independent predictors for death and morbidity in SARS patients. Metabolic control may improve the prognosis of SARS patients. Diabet. Med. 23, 623– 628 (2006) Keywords death, diabetes mellitus, prognosis, SARS, steroid Abbreviations DKA, diabetic ketoacidosis; FPG, fasting plasma glucose; SaO 2 , oxygen saturation; SARS, severe acute respiratory syndrome Blackwell Publishing Ltd Oxford, UK DME Diabetic Medicine 0742-3071 Blackwell Publishing, 2006 23 Original Article Original article Plasma glucose levels and diabetes in patients with SARS J. K. Yang et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS J. K. Yang, Y. Feng*, M. Y. Yuan†, S. Y. Yuan, H. J. Fu, B. Y. Wu, G. Z. Sun†, G. R. Yang, X. L. Zhang, L. Wang*, X. Xu*, X. P. Xu* and J. C. N. Chan‡ Department of Endocrinology, Affiliate of Capital University of Medical Sciences, Beijing Tongren Hospital, Beijing, China, *Program for Population Genetics, Harvard School of Public Health, Boston, MA, USA, †Department of Endocrinology, Beijing Chest Hospital, Beijing and ‡Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China Accepted 29 July 2005 Correspondence to: Prof. Jin-kui Yang, Department of Endocrinology, Affiliate of Capital University of Medical Sciences, Beijing Tongren Hospital, Beijing 100730, China. E-mail: yangjk@trhos.com