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Glucose control in hospitalized patients.

Publication ,  Journal Article
Sawin, G; Shaughnessy, AF
Published in: Am Fam Physician
May 1, 2010

Evidence indicates that hospitalized patients with hyperglycemia do not benefit from tight blood glucose control. Maintaining a blood glucose level of less than 180 mg per dL (9.99 mmol per L) will minimize symptoms of hyperglycemia and hypoglycemia without adversely affecting patient-oriented health outcomes. In the absence of modifying factors, physicians should continue patients' at-home diabetes mellitus medications and randomly check glucose levels once daily. Sulfonylureas should be withheld to avoid hypoglycemia in patients with limited caloric intake. Patients with cardiovascular conditions may benefit from temporarily stopping treatment with thiazolidinediones to avoid precipitating heart failure. Metformin should be temporarily withheld in patients who have worsening renal function or who will undergo an imaging study that uses contrast. When patients need to be treated with insulin in the short term, using a long-acting basal insulin combined with a short-acting insulin before meals (with the goal of keeping blood glucose less than 180 mg per dL) better approximates normal physiology and uses fewer nursing resources than sliding-scale insulin approaches. Most studies have found that infusion with glucose, insulin, and potassium does not improve mortality in patients with acute myocardial infarction. Patients admitted with acute myocardial infarction should have moderate control of blood glucose using home regimens or basal insulin with correctional doses.

Duke Scholars

Published In

Am Fam Physician

EISSN

1532-0650

Publication Date

May 1, 2010

Volume

81

Issue

9

Start / End Page

1121 / 1124

Location

United States

Related Subject Headings

  • Risk Factors
  • Outcome and Process Assessment, Health Care
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Insulin
  • Inpatients
  • Hypoglycemic Agents
  • Hyperglycemia
  • Humans
  • Hospitalization
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sawin, G., & Shaughnessy, A. F. (2010). Glucose control in hospitalized patients. Am Fam Physician, 81(9), 1121–1124.
Sawin, Gregory, and Allen F. Shaughnessy. “Glucose control in hospitalized patients.Am Fam Physician 81, no. 9 (May 1, 2010): 1121–24.
Sawin G, Shaughnessy AF. Glucose control in hospitalized patients. Am Fam Physician. 2010 May 1;81(9):1121–4.
Sawin, Gregory, and Allen F. Shaughnessy. “Glucose control in hospitalized patients.Am Fam Physician, vol. 81, no. 9, May 2010, pp. 1121–24.
Sawin G, Shaughnessy AF. Glucose control in hospitalized patients. Am Fam Physician. 2010 May 1;81(9):1121–1124.

Published In

Am Fam Physician

EISSN

1532-0650

Publication Date

May 1, 2010

Volume

81

Issue

9

Start / End Page

1121 / 1124

Location

United States

Related Subject Headings

  • Risk Factors
  • Outcome and Process Assessment, Health Care
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Insulin
  • Inpatients
  • Hypoglycemic Agents
  • Hyperglycemia
  • Humans
  • Hospitalization