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Downloads: Failure to control hyperglycemia in non-critically ill diabetic patients despite standard glycemic m

Downloads Home > Journal papers > Failure to control hyperglycemia in non-critically ill diabetic patients despite standard glycemic m

Failure to control hyperglycemia in non-critically ill diabetic patients despite standard glycemic m


Abstract
Background:
Successful control of hyperglycemia has been shown to improve outcomes for diabetes patients in a clinical
setting. We assessed the quality of physician-based glycemic management in two general wards, considering
the most recent recommendations for glycemic control for noncritically ill patients (<140 mg/dl for premeal
glucose).
Methods:
Quality of glycemic management of 50 patients in two wards (endocrinology, cardiology) was assessed
retrospectively by analyzing blood glucose (BG) levels, the glycemic management effort, and the online
questionnaire.
Results:
Glycemic control was clearly above the recommended target (mean BG levels: endocrinology: 175 62 mg/dl;
cardiology: 186 68 mg/dl). When comparing the first half with the second half of the hospital stay, we found
no difference in glycemic control (endocrinology: 168 32 vs 164 42 mg/dl, P = .67; cardiology: 174 36 mg/dl
vs 170 42 mg/dl, P =.51) and in insulin dose (endocrinology: 15 14 IU vs 15 13 IU per day, P = .87;
cardiology: 27 17 IU vs 27 18 IU per day, P = .92), despite frequent BG measurements (endocrinology: 2.7 per day;
cardiology: 3.2 per day). A lack of clearly defined BG targets was indicated in the questionnaire.
Conclusion:
The recommended BG target range was not achieved in both wards. Analysis of routine glycemic management
demonstrated considerable glycemic management effort, but also a lack of translation into adequate insulin
therapy. Implementation of corrective measures, such as structured treatment protocols, is essential.
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Louise Birch Riley
08. August 2013 14:00
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