| Optimizing inpatient glycemic control with basal-bolus insulin therapy. | |
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MedLine Citation:
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PMID: 21068533 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R Daniel Pollom |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Hospital practice (1995) Volume: 38 ISSN: 2154-8331 ISO Abbreviation: Hosp Pract (Minneap) Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-11 Completed Date: 2010-12-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101268948 Medline TA: Hosp Pract (Minneap) Country: United States |
Other Details:
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Languages: eng Pagination: 98-107 Citation Subset: AIM; IM |
Affiliation:
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Diabetes Care Center, Community Health Network, Indianapolis, IN 46216, USA. dpollom@ecommunity.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Hypoglycemic Agents; 0/basal insulin; 11061-68-0/Insulin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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