title: Glycemic control in the infectious diseases ward; role of clinical pharmacist interventions.
abstract: BACKGROUND
  Hyperglycemia is one of the most frequent metabolic complications in hospitalized patients. Increased risk of infection following hyperglycemia has been reported in hospitalized patients and infections may also cause insulin resistance which complicates the control of blood glucose level. In this study the impact of the clinical pharmacist interventions on the glycemic control in patients admitted to infectious diseases ward has been evaluated.
  
  
  METHODS
  We conducted a prospective, pre-post interventional study among patients with hyperglycemia. The clinical pharmacist-led multidisciplinary team managed the glycemic profile of patients according to an established insulin protocol commonly used in internal wards. Clinical pharmacists reviewed patients' medical charts for proper insulin administration, evaluated nurses' technique for insulin injection and blood glucose measurement, and educated patients about symptoms of hypoglycemia and the importance of adherence to different aspects of their glycemic management.
  
  
  RESULTS
  The percentage of controlled random blood sugar increased from 13.8% in the pre-intervention to 22.3% in the post-intervention group (p value < 0.01). On the other hand, the percentage of controlled fasting blood sugars in the post-intervention group was non-significantly higher than in the pre-intervention group.
  
  
  CONCLUSIONS
  Pharmacists and additional health care providers from other departments such as nursing and dietary departments need to be devoted to glycemic control service. Collaborative practice agreement between physicians is necessary to promote this service and help to increase the use of such services in different settings for diabetes control.
authors.affiliation: Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. sh.farsaei@yahoo.com.
authors.forename: Shadi
authors.initials: S
authors.lastname: Farsaei
authors.forename: Iman
authors.initials: I
authors.lastname: Karimzadeh
authors.forename: Sepideh
authors.initials: S
authors.lastname: Elyasi
authors.forename: Shima
authors.initials: S
authors.lastname: Hatamkhani
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007239:Infections / Q000150:complications*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D024382:Professional Role; D011446:Prospective Studies; D013312:Stress, Physiological; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin