Avoiding complications in the hospitalized patient: The case for tight glycemic control

Michota, Franklin A.; Braithwaite, Susan S.

doi:10.1002/jhm.182

J. Hosp. Med.

2007

DOI: 10.1002/jhm.182

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Avoiding complications in the hospitalized patient: The case for tight glycemic control

Franklin A. Michota¹,

Susan S. Braithwaite²

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Cited by 3 publications

References 58 publications

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How Low Can You Go? Reducing Rates of Hypoglycemia in the Non-critical Care Hospital Setting

Kulasa

Juang

2017

Curr Diab Rep

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Strategies to reduce hypoglycemia rates should focus on the most common causes of iatrogenic hypoglycemia. Creating a standardized insulin order set with built-in clinical decision support can help reduce rates of hypoglycemia. Coordination of blood glucose monitoring, meal tray delivery, and insulin administration is an important and challenging task. Protocols and processes should be in place to deal with interruptions in nutrition to minimize risk of hypoglycemia. A glucose management page that has all the pertinent information summarized in one page allows for active surveillance and quick identification of patients who may be at risk of hypoglycemia. Finally, education of prescribers, nurses, food and nutrition services, and patients is important so that every member of the healthcare team can work together to prevent hypoglycemia. By implementing strategies to reduce hypoglycemia, we hope to lower rates of adverse events and improve quality of care while also reducing hospital costs. Future research should focus on the impact of an overall reduction in hypoglycemia to determine whether the expected benefits are achieved.

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How Low Can You Go? Reducing Rates of Hypoglycemia in the Non-critical Care Hospital Setting

Kulasa

Juang

2017

Curr Diab Rep

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Continuous Glucose Monitor Shows Potential for Early Hypoglycemia Detection in Hospitalized Patients

Ryan¹,

Savarese²,

Hipszer³

et al. 2009

Diabetes Technology & Therapeutics

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Iatrogenic Inpatient Hypoglycemia: Risk Factors, Treatment, and Prevention

Maynard¹,

Huynh²,

Renvall³

2008

Diabetes Spectrum

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We performed a 130-patient case-control study to examine the patient and hospital care risk factors for experiencing a hypoglycemic patient-day, comparing these factors to similar control patients who were not experiencing a hypoglycemic patient-day. We also examined adherence to our hypoglycemia management protocols, documentation of the event, and adjustments to medications and nutritional regimens that occurred in response to the hypoglycemic event. The most powerful risk factors for hypoglycemia were unexpected nutritional interruption, prior hypoglycemia during the hospital stay, and asynchrony of nutrition delivery and insulin administration. Adherence to hypoglycemia management and documentation standards was poor. Here, we outline strategies to focus improvement efforts on adherence to hypoglycemia treatment protocols and proactive management of patients with these key hypoglycemia risk factors.

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Avoiding complications in the hospitalized patient: The case for tight glycemic control

Cited by 3 publications

References 58 publications

How Low Can You Go? Reducing Rates of Hypoglycemia in the Non-critical Care Hospital Setting

How Low Can You Go? Reducing Rates of Hypoglycemia in the Non-critical Care Hospital Setting

Continuous Glucose Monitor Shows Potential for Early Hypoglycemia Detection in Hospitalized Patients

Iatrogenic Inpatient Hypoglycemia: Risk Factors, Treatment, and Prevention

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