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Glycemic management in the inpatient setting.
Hosp Pract (1995). 2012 Apr; 40(2):44-55.HP

Abstract

Hyperglycemia occurs frequently in hospitalized patients and affects patient outcomes, including mortality, inpatient complications, hospital length of stay, and overall hospital costs. Various degrees of glycemic control have been studied and consensus statements from the American Diabetes Association/American Association of Clinical Endocrinologists and The Endocrine Society recommend a target blood glucose range of 140 to 180 mg/dL in most hospitalized patients. Insulin is the preferred modality for treating all hospitalized patients with hyperglycemia, as it is adaptable to changing patient physiology over the course of hospitalization. Critically ill patients should receive intravenous insulin infusion, and all noncritically ill patients with hyperglycemia (individuals with and without diabetes) should be managed using a subcutaneous insulin algorithm with basal, nutritional, and correctional dose components. Hypoglycemia remains a limiting factor to achieving optimal glycemic targets. Similar to hyperglycemia, hypoglycemia is an independent risk factor for poor outcomes in hospitalized patients. Improvement in glycemic control throughout the hospital includes efforts from all health care providers. Institutions can encourage safe insulin use by using insulin algorithms, preprinted order sets, and hypoglycemia protocols, as well as by supporting patient and health care provider education.

Authors+Show Affiliations

Assistant Professor, Oakland University William Beaumont School of Medicine, Rochester, MI; Associated Endocrinologists, PC and Endocrine Hospital Consultants, PC, West Bloomfield, MI; Chief of Endocrinology, Detroit Medical Center-Huron Valley-Sinai Hospital, Commerce, MI; Department of Endocrinology, William Beaumont Hospital, Royal Oak, MI. schmeltz@endocrinemds.com.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22615078

Citation

Schmeltz, Lowell R., and Carla Ferrise. "Glycemic Management in the Inpatient Setting." Hospital Practice (1995), vol. 40, no. 2, 2012, pp. 44-55.
Schmeltz LR, Ferrise C. Glycemic management in the inpatient setting. Hosp Pract (1995). 2012;40(2):44-55.
Schmeltz, L. R., & Ferrise, C. (2012). Glycemic management in the inpatient setting. Hospital Practice (1995), 40(2), 44-55. https://doi.org/10.3810/hp.2012.04.969
Schmeltz LR, Ferrise C. Glycemic Management in the Inpatient Setting. Hosp Pract (1995). 2012;40(2):44-55. PubMed PMID: 22615078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycemic management in the inpatient setting. AU - Schmeltz,Lowell R, AU - Ferrise,Carla, PY - 2012/5/23/entrez PY - 2012/5/23/pubmed PY - 2014/8/22/medline SP - 44 EP - 55 JF - Hospital practice (1995) JO - Hosp Pract (1995) VL - 40 IS - 2 N2 - Hyperglycemia occurs frequently in hospitalized patients and affects patient outcomes, including mortality, inpatient complications, hospital length of stay, and overall hospital costs. Various degrees of glycemic control have been studied and consensus statements from the American Diabetes Association/American Association of Clinical Endocrinologists and The Endocrine Society recommend a target blood glucose range of 140 to 180 mg/dL in most hospitalized patients. Insulin is the preferred modality for treating all hospitalized patients with hyperglycemia, as it is adaptable to changing patient physiology over the course of hospitalization. Critically ill patients should receive intravenous insulin infusion, and all noncritically ill patients with hyperglycemia (individuals with and without diabetes) should be managed using a subcutaneous insulin algorithm with basal, nutritional, and correctional dose components. Hypoglycemia remains a limiting factor to achieving optimal glycemic targets. Similar to hyperglycemia, hypoglycemia is an independent risk factor for poor outcomes in hospitalized patients. Improvement in glycemic control throughout the hospital includes efforts from all health care providers. Institutions can encourage safe insulin use by using insulin algorithms, preprinted order sets, and hypoglycemia protocols, as well as by supporting patient and health care provider education. SN - 2154-8331 UR - https://www.unboundmedicine.com/medline/citation/22615078/Glycemic_management_in_the_inpatient_setting_ L2 - https://medlineplus.gov/hyperglycemia.html DB - PRIME DP - Unbound Medicine ER -