INS and gangrene: Inclusion criteria consisted of adults with a diagnosis of diabetes ≥18yrs, presenting to intensive care unit (ICU) (39, 43, 44), having a hospital stay of more than 48 hours (41), with diabetic foot ulcer, gangrene, cellulitis or infection as the primary cause of admission (31, 46), cardiovascular disease (47), diabetes ketoacidosis (38, 40, 45), hyperglycaemia (35), receiving insulin therapy (32, 42) and undergoing elective surgery (44).