| Popis: |
Morning diabetes management in an inpatient acute care facility was examined.A descriptive, nonexperimental research design was used to study the effect of the following variables on patients' prelunch blood glucose: duration of time between (1) blood glucose monitoring and insulin administration, (2) insulin administration and breakfast, and (3) blood glucose monitoring and breakfast. A nonprobability convenience sample was used to examine 40 adults with diabetes who were hospitalized in an urban, academic medical center.The chi2 test and measurements of central tendency were used for statistical analysis. The mean interval of time between (1) blood glucose monitoring and insulin administration was 93 minutes+/-52.82, (2) blood glucose monitoring and breakfast was 121+/-47 minutes, and (3) insulin administration and breakfast was 73+/-37.06 minutes. Insulin was administered in 28% of patients45 minutes before breakfast, whereas in 39% and 33%, it was administered between 46 and 90 minutes and90 minutes prior to breakfast, respectively. There was a statistically significant difference (P=.033) between mean prelunch glucose levels for subjects who received insulin45 minutes before breakfast and mean glucose levels for those who received insulin45 minutes before breakfast. Eighty percent of patients whose breakfast was45 minutes following insulin had prelunch glucose values of180 mg/dL (10 mmol/L) versus 20%180 mg/dL (10 mmol/L). Of those whose breakfast was45 minutes before insulin, 43% had blood glucose levels180 mg/dL, and 57% had blood glucose180 mg/dL (P=.026). A logistical regression model revealed that patients had a 5.3 times higher risk of having a prelunch blood glucose level180 mg/dL when their breakfast time was45 minutes after receiving insulin as compared to those whose insulin was given45 minutes before breakfast (relative risk, 5.3; 95% confidence interval, 1.2-25; P=.031).Current practice suggests patients are at a higher risk of prelunch hyperglycemia, and multiple opportunities exist to improve care for the inpatient with diabetes. |
