title: Practical approach to management of inpatient hyperglycemia in select patient populations.
abstract: Hospitalized patients frequently transition between various levels of care and changing clinical situations. Optimal management of hospitalized patients with hyperglycemia includes awareness of situations that may significantly affect glucose and/or insulin metabolism. A review of published clinical trials reveals practical approaches to the management of hyperglycemia in select patient populations that may prove useful for the hospital clinician. We outline approaches to the management of hyperglycemia in hospitalized patients receiving glucocorticoids, patients with severe or end-stage renal disease undergoing hemo- or peritoneal dialysis, and patients receiving total parenteral or enteral feeding, in addition to patients transitioning from intravenous insulin infusion to subcutaneously administered insulin. Key considerations underlying these management methods include a proactive approach, frequent blood glucose monitoring, daily review of blood glucose patterns, and daily reassessment of the insulin regimen and associated orders.
authors.affiliation: Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA. cecilia.wang@UCDenver.edu
authors.forename: Cecilia C
authors.initials: CC
authors.lastname: Low Wang
authors.forename: Boris
authors.initials: B
authors.lastname: Draznin
mesh_terms: D048909:Diabetes Complications / Q000628:therapy; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006761:Hospitals; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007336:Insulin, Isophane / Q000008:administration & dosage / Q000494:pharmacology; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy
chemical_list: D005938:Glucocorticoids; D007328:Insulin; D007336:Insulin, Isophane