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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

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
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
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.
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.

08. August 2013 14:00
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