title: Achieving glycemic control in special populations in hospital: perspectives in practice.
abstract: Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly.
authors.affiliation: Division of Endocrinology and Metabolism, University of Toronto, Toronto, Canada. Electronic address: chenga@smh.ca.
authors.forename: Alice Y Y
authors.initials: AY
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D003927:Diet, Diabetic; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D018570:Risk Assessment
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: alimentation entérale; alimentation parentérale; alimentation parentérale totale; diabetes; diabète; en milieu hospitalier; enteral feeding; glucocorticoïdes; glucorticoids; glycemic control; in-hospital; parenteral feeding; régulation glycémique; steroids; stéroïdes; total parental feeding (TPN)