Management of Inpatient Hyperglycemia in Special Populations

Management of Inpatient Hyperglycemia in Special Populations

Key Points

  • Hyperglycemia is associated with adverse clinical outcomes in the hospital setting, both in critically ill and noncritically ill patients.

  • National organizations have promoted safe and achievable glucose targets for inpatients.

  • Special considerations are necessary for patients

    • On enteral or parenteral nutrition

    • Receiving steroids

    • Using insulin pumps

  • Established pre-op procedures are also important to optimize glucose control during surgery.

Suggested Reading

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Bochicchio GV, Joshi M, Bochicchio KM, et al. Early hyperglycemic control is important in critically injured trauma patients. J Trauma. 2007;63:1353-1358.

Donihi AC, Raval D, Saul M, Korytkowski MT, DeVita MA. Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocr Pract. 2006;12:358-362.

Frisch A, Chandra P, Smiley D, et al. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010;33:1783-1788.

Kumar PR, Crotty P, Raman M. Hyperglycemia in hospitalized patients receiving parental nutrition is associated with increased morbidity and mortality: a review. Gastroenterol Res Pract. 2011;2011. doi:pii: 760720. Epub 2010 Aug 3.

McAlister FA, Majumdar SR, Blitz S, et al. The relation between hyperglycemia and outcomes in 2,471 patients admitted to the hospital with community-acquired pneumonia. Diabetes Care. 2005;28:810-815.

Nassar AA, Partlow BJ, Boyle ME, Castro JC, Bourgeois PB, Cook CB. Outpatient-to-inpatient transition of insulin pump therapy: successes and continuing challenges. J Diabetes Sci Technol. 2010;4:863-872.

Noschese ML, DiNardo MM, Donihi AC, et al. Patient outcomes after implementation of a protocol for inpatient insulin pump therapy. Endocr Pract. 2009;15:415-424.

Palacio A, Smiley D, Ceron M, et al. Prevalence and clinical outcome of inpatient hyperglycemia in a community pediatric hospital. J Hosp Med. 2008;3:212-217.

Pancorbo-Hidalgo PL, García-Fernandez FP, Ramírez-Pérez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. J Clin Nurs. 2001;10:482-490.

Pasquel FJ, Spiegelman R, McCauley M, et al. Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients. Diabetes Care. 2010;33:739-741.

Pasquel FJ, Spiegelman R, McCauley M, et al. Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients. Diabetes Care. 2010;33:739-41.

Schlenk F, Vajkoczy P, Sarrafzadeh A. Inpatient hyperglycemia following aneurysmal subarachnoid hemorrhage: relation to cerebral metabolism and outcome. Neurocrit Care. 2009;11:56-63.

Ukleja A, Freeman KL, Gilbert K, Kochevar M, Kraft MD, Russell MK, Shuster MH; Task Force on Standards for Nutrition Support: Adult Hospitalized Patients, and the American Society for Parenteral and Enteral Nutrition Board of Directors. Standards for nutrition support: adult hospitalized patients. Nutr Clin Pract. 2010;25:403-414.

Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978-982.