Document Detail


Optimizing inpatient glycemic control with basal-bolus insulin therapy.
MedLine Citation:
PMID:  21068533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hyperglycemia is highly prevalent in the acute-care setting and is associated with an increased risk of morbidity and mortality. Evidence suggests that glycemic control in this population is suboptimal, due in part to continued use of nonphysiologic sliding-scale insulin strategies without scheduled basal insulin doses or prandial insulin with concomitant correction doses. Although the ineffectiveness and risks of sliding-scale insulin regimens have been criticized for decades, sliding-scale insulin is still the most commonly prescribed subcutaneous insulin regimen among inpatients. Improving inpatient management requires the use of scheduled basal-bolus insulin therapy that includes basal insulin, nutritional insulin, and supplemental, or correctional, insulin. Insulin analogs are the preferred insulins, as they provide a more physiologic action than human insulin regimens, are associated with a lower risk of hypoglycemia, and are more convenient to administer than human insulins. Standardized insulin protocols and subcutaneous insulin order sets are critical components of effective inpatient glycemic control. Although preliminary data have demonstrated that inpatient diabetes management programs involving basal-bolus insulin therapy are effective and well tolerated, more research is needed.
Authors:
R Daniel Pollom
Related Documents :
20515303 - Insulin pump use in europe.
17476613 - Insulin resistance in patients with rheumatoid arthritis: effect of anti-tnfalpha therapy.
17974133 - Gender-associated differences in metabolic syndrome-related parameters in göttingen mi...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hospital practice (1995)     Volume:  38     ISSN:  2154-8331     ISO Abbreviation:  Hosp Pract (Minneap)     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101268948     Medline TA:  Hosp Pract (Minneap)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  98-107     Citation Subset:  AIM; IM    
Affiliation:
Diabetes Care Center, Community Health Network, Indianapolis, IN 46216, USA. dpollom@ecommunity.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Clinical Protocols
Cost of Illness
Cost-Benefit Analysis
Drug Administration Schedule
Hospitalists / economics,  methods*
Humans
Hyperglycemia / drug therapy*,  epidemiology,  etiology,  metabolism
Hypoglycemic Agents / administration & dosage*
Injections, Intravenous
Injections, Subcutaneous
Inpatients* / statistics & numerical data
Insulin / administration & dosage*,  analogs & derivatives
Insulin Infusion Systems
Nutritional Support
Patient Discharge
Physician's Practice Patterns
Practice Guidelines as Topic
Prevalence
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/basal insulin; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Resistant hypertension in office practice: a clinical approach.
Next Document:  Antimicrobial resistance in Hispanic patients hospitalized in San Antonio, TX with community-acquire...