Systematic strategies for improved outcomes for the hyperglycemic hospitalized patient with diabetes mellitus.
Diabetes mellitus is reaching epidemic proportions in the United States. It is now the fourth most common comorbid condition complicating hospital discharges. There is a rapidly evolving body of literature assessing the short-term and long-term effects of strict glycemic control in the hospital setting. Results from several landmark studies have challenged the long-held notion that stress hyperglycemia is beneficial. This article will focus on these studies, postulated mechanisms of action, and finally, description of an insulin infusion protocol developed at a community hospital for patients undergoing cardiac surgery.
Vasa
Falguni
F
Edward Hospital, Naperville, Illinois, USA. falgunivasa@sbcglobal.net
D006348:Cardiac Surgical Procedures; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D004334:Drug Administration Schedule; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States
D007004:Hypoglycemic Agents; D007328:Insulin