Why Should You Act?
- Hyperglycemia is associated with poor outcomes in a broad range of
hospitalized patients, and several studies demonstrate improved outcomes
with improved glycemic control.1
- Hospitalization presents a frequently missed opportunity to diagnose
diabetes, identify those at risk for diabetes, and to optimize the care
of patients with diabetes via education and medical therapy.2,
4
- Despite authoritative guidelines and effective methods to achieve
good glycemic control safely, poor glycemic control, suboptimal
medication regimens, incomplete patient education, and uneven
communication with outpatient care providers are prevalent problems in
medical centers.3,
4
The Role of the Hospitalist
Provide excellent care for the individual inpatient with
hyperglycemia and diabetes, including the expert use of insulin for
patients in all nutritional situations.
Lead, coordinate, or participate in initiatives to improve the care
of the patient population with hyperglycemia and diabetes in the
hospital setting. This may include participation in multidisciplinary
teams, which may include nursing and social services, nutrition,
pharmacy, and endocrinology, to facilitate patient education, implement
order sets, algorithms, and policies to achieve improved glycemic
control and reduce iatrogenic hypoglycemia, to improve patient function
and outcomes, and advocate patient outreach post discharge. More
Like This.
Fundamental Principle for Glycemic Control
Insulin infusion or physiologic subcutaneous insulin regimens that
are tailored to the patient's nutritional status and other factors are
the best ways to control hyperglycemia in the hospital. The
implementation of such regimens can only be safe and effective in
improving glycemic control when achieved with a multidisciplinary
team.
The Glycemic
Control Workbook, which can be found in the Improve section of this
resource room, is the premier resource for comprehensive information on
implementing a quality improvement initiative that optimizes glycemic
control and minimizes hypoglycemia in your institution.
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