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 |
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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 ( |
doi_str_mv | 10.2337/dc12-2508 |
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Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (<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. Hygiene-occupational medicine ; s in Care</subject><ispartof>Diabetes care, 2013-07, Vol.36 (7), p.1807-1814</ispartof><rights>2014 INIST-CNRS</rights><rights>COPYRIGHT 2013 American Diabetes Association</rights><rights>Copyright American Diabetes Association Jul 2013</rights><rights>2013 by the American Diabetes Association. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c538t-a31d0bc08e220627054d059017c38c8b1a57dde7f19906472b30fe1baa0a3b433</citedby><cites>FETCH-LOGICAL-c538t-a31d0bc08e220627054d059017c38c8b1a57dde7f19906472b30fe1baa0a3b433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27504803$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23801791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DRAZNIN, Boris</creatorcontrib><creatorcontrib>GILDEN, Janice</creatorcontrib><creatorcontrib>GOLDEN, Sherita H</creatorcontrib><creatorcontrib>INZUCCHI, Silvio E</creatorcontrib><creatorcontrib>PRIDE investigators</creatorcontrib><creatorcontrib>for the PRIDE investigators</creatorcontrib><title>Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><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 (<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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Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (<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.</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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