Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action

Currently patients with diabetes comprise up to 25-30% of the census of adult wards and critical care units in our hospitals. Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (

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Veröffentlicht in:Diabetes care 2013-07, Vol.36 (7), p.1807-1814
Hauptverfasser: DRAZNIN, Boris, GILDEN, Janice, GOLDEN, Sherita H, INZUCCHI, Silvio E
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container_issue 7
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container_title Diabetes care
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creator DRAZNIN, Boris
GILDEN, Janice
GOLDEN, Sherita H
INZUCCHI, Silvio E
description Currently patients with diabetes comprise up to 25-30% of the census of adult wards and critical care units in our hospitals. Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (
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Although evidence suggests that avoidance of hyperglycemia (&gt;180 mg/dL) and hypoglycemia (&lt;70 mg/dL) is beneficial for positive outcomes in the hospitalized patient, much of this evidence remains controversial and at times somewhat contradictory. We have recently formed a consortium for Planning Research in Inpatient Diabetes (PRIDE) with the goal of promoting clinical research in the area of management of hyperglycemia and diabetes in the hospital. In this article, we outline eight aspects of inpatient glucose management in which randomized clinical trials are needed. We refer to four as system-based issues and four as patient-based issues. We urge further progress in the science of inpatient diabetes management. We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc12-2508</identifier><identifier>PMID: 23801791</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Biological and medical sciences ; Blood Glucose - drug effects ; Design ; Dextrose ; Diabetes ; Diabetes Mellitus - blood ; Diabetes Mellitus - drug therapy ; Diabetes therapy ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Evidence-based medicine ; Glucose ; Glucose metabolism ; Hospitalization ; Hospitals ; Humans ; Hyperglycemia ; Hyperglycemia - blood ; Hyperglycemia - drug therapy ; Hypoglycemic Agents - therapeutic use ; Inpatients ; Medical sciences ; Metabolic diseases ; Miscellaneous ; Mortality ; Pharmaceutical industry ; Public health. Hygiene ; Public health. 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Although evidence suggests that avoidance of hyperglycemia (&gt;180 mg/dL) and hypoglycemia (&lt;70 mg/dL) is beneficial for positive outcomes in the hospitalized patient, much of this evidence remains controversial and at times somewhat contradictory. We have recently formed a consortium for Planning Research in Inpatient Diabetes (PRIDE) with the goal of promoting clinical research in the area of management of hyperglycemia and diabetes in the hospital. In this article, we outline eight aspects of inpatient glucose management in which randomized clinical trials are needed. We refer to four as system-based issues and four as patient-based issues. We urge further progress in the science of inpatient diabetes management. We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - drug effects</subject><subject>Design</subject><subject>Dextrose</subject><subject>Diabetes</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Evidence-based medicine</subject><subject>Glucose</subject><subject>Glucose metabolism</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - blood</subject><subject>Hyperglycemia - drug therapy</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Inpatients</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Miscellaneous</subject><subject>Mortality</subject><subject>Pharmaceutical industry</subject><subject>Public health. Hygiene</subject><subject>Public health. 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Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Evidence-based medicine</topic><topic>Glucose</topic><topic>Glucose metabolism</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hyperglycemia - blood</topic><topic>Hyperglycemia - drug therapy</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Inpatients</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Miscellaneous</topic><topic>Mortality</topic><topic>Pharmaceutical industry</topic><topic>Public health. Hygiene</topic><topic>Public health. 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We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>23801791</pmid><doi>10.2337/dc12-2508</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Biological and medical sciences
Blood Glucose - drug effects
Design
Dextrose
Diabetes
Diabetes Mellitus - blood
Diabetes Mellitus - drug therapy
Diabetes therapy
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Evidence-based medicine
Glucose
Glucose metabolism
Hospitalization
Hospitals
Humans
Hyperglycemia
Hyperglycemia - blood
Hyperglycemia - drug therapy
Hypoglycemic Agents - therapeutic use
Inpatients
Medical sciences
Metabolic diseases
Miscellaneous
Mortality
Pharmaceutical industry
Public health. Hygiene
Public health. Hygiene-occupational medicine
s in Care
title Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action
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