Safe Insulin Use in the Hospital Setting
| Autor: | Lowell R Schmeltz |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
Medication Systems Hospital Safety Management medicine.medical_specialty Injections Subcutaneous medicine.medical_treatment Hypoglycemia Drug Administration Schedule Diabetes Complications Insulin Infusion Systems Clinical Protocols Diabetes mellitus Health care medicine Risk of mortality Humans Insulin Practice Patterns Physicians' Intensive care medicine Glycemic Glycated Hemoglobin Inpatients business.industry General Medicine medicine.disease Patient Discharge United States INSULIN USE Diabetes Mellitus Type 2 Basal (medicine) Hyperglycemia Injections Intravenous business Algorithms |
| Zdroj: | Hospital Practice. 37:51-59 |
| ISSN: | 2377-1003 2154-8331 |
| Popis: | Inpatients have a high rate of diabetes (12%-26%) and hyperglycemia (~38%). All patients should have their glycosylated hemoglobin (A1C) checked on admission to help differentiate between long-term and new-onset hyperglycemia. Good glycemic control throughout the hospital stay is associated with decreases in short- and long-term risk of mortality, inpatient complications, length of hospital stay, and health care costs. Insulin is first-line therapy for hyperglycemia; patients with hyperglycemia should be managed using either intravenous (IV) or subcutaneous (SC) insulin algorithms. A hypoglycemia management protocol should be in place at the hospital for safety purposes. For successful glycemic control, insulin algorithms should have dynamic scales, require frequent glucose monitoring, and be simple and easy to use. The algorithm should address transitioning patients from IV to SC insulin and a discharge plan. Insulin analogues are preferred for basal, mealtime, and correction doses instead of human insulins (regular and NPH) because analogues have a more predictable absorption and action profile and less pharmacokinetic fluctuation. Institutions can increase safe insulin use by utilizing insulin algorithms, preprinted order sets, and hypoglycemia protocols; by supporting patient and health care provider education; and by implementing needle-stick prevention techniques. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|