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hyperglycemia in inpatient

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https://www.readbyqxmd.com/read/29862091/a-case-of-factitious-hyperglycemia-in-a-patient-on-intravenous-ascorbic-acid
#1
Eliza Sharma, Christine Resta, Patricia Park
Finger stick blood glucose meters are widely used in outpatient and inpatient settings. However, various factors can affect accuracy of readings from these meters. Here we present a patient who had spurious glucose elevation on these meters while being on intravenous ascorbic acid.
2018: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29778650/obesity-surgery-makes-patients-healthier-and-more-functional-real-world-results-from-the-united-kingdom-national-bariatric-surgery-registry
#2
Alexander Dimitri Miras, Kamocka Anna, Patel Darshan, Dexter Simon, Finlay Ian, Hopkins C James, Khan Omar, Reddy Marcus, Sedman Peter, Small Peter, Somers Shaw, Suzie Cro, Walton Peter, le Roux Carel W, Welbourn Richard
BACKGROUND: The National Bariatric Surgery Registry (NBSR) is the largest bespoke database in the field in the United Kingdom. OBJECTIVES: Our aim was to analyze the NBSR to determine whether the effects of obesity surgery on associated co-morbidities observed in small, randomized controlled clinical trials could be replicated in a "real life" setting within U.K. healthcare. SETTING: United Kingdom. METHODS: All NBSR entries for operations between 2000 and 2015 with associated demographic and co-morbidity data were analyzed retrospectively...
February 15, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29777522/impact-of-insulin-degludec-in-hospitalized-patients-with-and-without-type-2-diabetes-requiring-parenteral-enteral-nutrition-an-observational-study
#3
Giuseppe Fatati, Agnese Di Donato, Ilenia Grandone, Pina Menicocci, Eva Mirri, Giuseppe Prosperini, Marco Scardapane, Maria Chiara Rossi, Mariangela Palazzi
INTRODUCTION: Hyperglycemia in inpatients is a major problem, especially when nutritional support is required. This study aims to assess the impact of treatment with insulin degludec (IDeg) on mean blood glucose (BG) and glycemic variability in noncritical hospitalized patients with and without type 2 diabetes (T2DM) receiving enteral and/or parenteral nutrition (EN, PN). METHODS: Mean BG and glycemic variability from admission up to 7 days of hospitalization were evaluated in consecutive cases with and without T2DM...
May 17, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#4
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29689388/neutrophil-and-platelet-to-lymphocyte-ratios-in-associating-with-blood-glucose-admission-predict-the-functional-outcomes-of-patients-with-primary-brainstem-hemorrhage
#5
F Zhang, H Li, C Tao, J Zheng, X Hu, S Lin, J Qian, C You, M Yang
BACKGROUND: Due to lack of markers for predicting the prognosis as well as the under mechanism is unrevealed, patients with primary brainstem hemorrhage (PBH) were currently treated by multi-strategies but most of them have poor outcomes by comparing with supratentorial intracranial hemorrhage patients. Recently, it has been reported that the ratio of neutrophil to lymphocyte (NLR) represents a novel composite inflammatory marker to predict the prognosis of patients with intracranial hemorrhage, where majority are supratentorial hemorrhage...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29688879/managing-diabetes-in-patients-hospitalized-in-internal-medicine-units
#6
Irit Hochberg
Diabetes and hyperglycemia are present in over one-third of inpatients in internal medicine units and are associated with worse prognosis in multiple morbidities. Treatment of inpatient hyperglycemia is usually with basal bolus insulin in a dose calculated by the patient's weight, with lower doses recommended in patients who are at a higher risk for hypoglycemia. Other antihyperglycemic medications and insulin regimens can be used in selected patients. There are no adequately powered studies on the effect of improving glycemic control on hospitalization outcomes in non-critically ill patients in internal medicine units, and in most patients a modest glucose target of 140-180 mg/dL is recommended...
April 19, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29596400/trends-in-diabetic-ketoacidosis-hospitalizations-and-in-hospital-mortality-united-states-2000-2014
#7
Stephen R Benoit, Yan Zhang, Linda S Geiss, Edward W Gregg, Ann Albright
Diabetes is a common chronic condition and as of 2015, approximately 30 million persons in the United States had diabetes (23 million with diagnosed and 7 million with undiagnosed) (1). Diabetic ketoacidosis (DKA) is a life-threatening but preventable complication of diabetes characterized by uncontrolled hyperglycemia (>250 mg/dL), metabolic acidosis, and increased ketone concentration that occurs most frequently in persons with type 1 diabetes (2). CDC's United States Diabetes Surveillance System* (USDSS) indicated an increase in hospitalization rates for DKA during 2009-2014, most notably in persons aged <45 years...
March 30, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29575924/what-can-we-learn-from-point-of-care-blood-glucose-values-deleted-and-repeated-by-nurses
#8
Dawn Corl, Tom Yin, May Ulibarri, Heather Lien, Tracy Tylee, Jing Chao, Brent E Wisse
BACKGROUND: Hospitals rely on point-of-care (POC) blood glucose (BG) values to guide important decisions related to insulin administration and glycemic control. Evaluation of POC BG in hospitalized patients is associated with measurement and operator errors. Based on a previous quality improvement (QI) project we introduced an option for operators to delete and repeat POC BG values suspected as erroneous. The current project evaluated our experience with deleted POC BG values over a 2-year period...
March 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29555341/knowledge-translation-to-optimize-adult-inpatient-glycemic-management-with-basal-bolus-insulin-therapy-and-improve-patient-outcomes
#9
Karmon E Helmle, Sunita Chacko, Trevor Chan, Alison Drake, Alun L Edwards, Glenda E Moore, Leta C Philp, Naomi Popeski, Rhonda L Roedler, Edwin J R Rogers, Gabrielle L Zimmermann, Julie McKeen
OBJECTIVES: To develop and evaluate a Basal Bolus Insulin Therapy (BBIT) Knowledge Translation toolkit to address barriers to adoption of established best practice with BBIT in the care of adult inpatients. METHODS: This study was conducted in 2 phases and focused on the hospitalist provider group across 4 acute care facilities in Calgary. Phase 1 involved a qualitative evaluation of provider and site specific barriers and facilitators, which were mapped to validated interventions using behaviour change theory...
December 27, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29553071/association-between-diabetic-microangiopathies-and-glycemic-variability-assessed-by-continuous-glucose-monitoring
#10
Satomi Sonoda, Yosuke Okada, Hiroko Mori, Fumi Uemura, Kei Sugai, Maiko Hajime, Kenichi Tanaka, Akira Kurozumi, Manabu Narisawa, Keiichi Torimoto, Yoshiya Tanaka
The aim of this retrospective study was to elucidate the association between glucose profile using the continuous glucose monitoring system (CGMS) and microvascular complications in patients with type 2 diabetes mellitus (T2DM). The subjects were 160 inpatients with T2DM. The mean blood glucose (MBG) level, percentage of time in a 24-hour period spent with blood glucose level higher than 180 mg/dl (time at >180 mg/dl), standard deviation (SD), and mean amplitude of glycemic excursions (MAGE) were measured continuously over 48 hours using the CGMS...
2018: Journal of UOEH
https://www.readbyqxmd.com/read/29550098/evaluating-the-emergency-department-observation-unit-for-the-management-of-hyperglycemia-in-adults
#11
Colin J Crilly, Amy J Allen, Teresa M Amato, Allison Tiberio, Rifka C Schulman, Robert A Silverman
OBJECTIVE: To determine whether hyperglycemic patients can be successfully managed in the Emergency Department Observation Unit (EDOU), as determined by the frequency of inpatient admission following their EDOU stay. METHODS: This was a retrospective chart review of patients≥18years presenting to an academic tertiary care ED between May 1, 2014 and May 31, 2016, found to have a glucose≥300mg/dL, and selected for EDOU admission. Patient demographic information, lab results including an HbA1c, disposition, and hospital revisits within 30days of discharge were recorded...
February 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29442175/common-models-used-for-inpatient-diabetes-management
#12
REVIEW
Andjela T Drincic, Padmaja Akkireddy, Jon T Knezevich
PURPOSE OF REVIEW: Diabetes affects about a third of all hospitalized patients and up to 50% of inpatients go on to experience hyperglycemia. Despite strong evidence supporting the importance of adequate glycemic control, as well detailed guidelines from major national organizations, many patients continue to have hypo- and hyperglycemia during their hospital stay. While this may be partially related to provider and patient-specific factors, system-based barriers continue to pose a major obstacle...
February 14, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29431513/safety-and-feasibility-of-the-omnipod-hybrid-closed-loop-system-in-adult-adolescent-and-pediatric-patients-with-type-1-diabetes-using-a-personalized-model-predictive-control-algorithm
#13
Bruce A Buckingham, Gregory P Forlenza, Jordan E Pinsker, Mark P Christiansen, R Paul Wadwa, Jennifer Schneider, Thomas A Peyser, Eyal Dassau, Joon Bok Lee, Jason O'Connor, Jennifer E Layne, Trang T Ly
BACKGROUND: The safety and feasibility of the OmniPod personalized model predictive control (MPC) algorithm in adult, adolescent, and pediatric patients with type 1 diabetes were investigated. METHODS: This multicenter, observational trial included a 1-week outpatient sensor-augmented pump open-loop phase and a 36-h inpatient hybrid closed-loop (HCL) phase with announced meals ranging from 30 to 90 g of carbohydrates and limited physical activity. Patients aged 6-65 years with HbA1c between 6...
April 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29407051/hyperglycemia-in-acute-coronary-syndromes-from-mechanisms-to-prognostic-implications
#14
REVIEW
Mikhail Kosiborod
Numerous studies have documented that hyperglycemia is frequent in patients hospitalized with acute coronary syndromes, affects patients with and without established diabetes, and is associated with adverse outcomes, with incremental increase in risk of mortality and complications observed across the spectrum of glucose elevations. This article reviews present knowledge about the association between glucose levels and outcomes of patients hospitalized with acute coronary syndromes; describes available data regarding inpatient glucose management in this patient group, and comparative data across the spectrum of critically ill hospitalized patients; addresses some controversies in this field; and offers practical recommendations for patient management based on existing data...
March 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29357807/hyperglycemia-in-hospitalized-diabetic-non-critically-ill-patients-prevalence-correlates-management-and-nurses-attitudes
#15
Ghada El Khoury, Hanine Mansour, Wissam Kabbara, Nibal Chamoun, Nadim Attalah, Pascale Salameh
BACKGROUND: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to, decrease length of hospital stay and to reduce complications and readmissions. OBJECTIVE: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients...
January 19, 2018: Current Diabetes Reviews
https://www.readbyqxmd.com/read/29346740/role-of-the-diabetes-educator-in-inpatient-diabetes-management
#16
(no author information available yet)
It is the position of American Association of Diabetes Educators (AADE) that all inpatient interdisciplinary teams include a diabetes educator to lead or support improvement efforts that affect patients hospitalized with diabetes or hyperglycemia. This not only encompasses patient and family education but education of interdisciplinary team members and achievement of diabetes-related organizational quality metrics and performance outcomes.
February 2018: Diabetes Educator
https://www.readbyqxmd.com/read/29251063/decreased-rates-of-inpatient-hypoglycemia-following-implementation-of-an-automated-tool-in-the-electronic-medical-record-for-identifying-root-causes
#17
Naina Sinha Gregory, Jane Jeffrie Seley, Jenny Ukena, Sona Shah, Matthew R Fred, Savira Kochhar Dargar, Elizabeth Mauer, Robert J Kim
OBJECTIVE: The objective was to identify root causes of hypoglycemia on medicine inpatient units using an automated tool. Data collected will guide educational interventions aimed at improving patient care and safety by decreasing rates of hypoglycemia. METHODS: A survey was conducted among RNs to identify risk factors for hypoglycemia. Survey data were used to create a hypoglycemia root cause survey tool in the EMR. RNs were prompted to utilize the tool when blood glucose (BG) < 70 mg/dL...
January 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29237289/safely-converting-an-entire-academic-medical-center-from-sliding-scale-to-basal-bolus-insulin-via-implementation-of-the-eglycemic-management-system
#18
Rosalina Newsom, Christopher Patty, Emma Camarena, Regina Sawyer, Raymie McFarland, Thomas Gray, Melanie Mabrey
OBJECTIVE: Hyperglycemia is common in the inpatient setting and providers frequently rely on sliding scale insulin. This case study reviews the experience of one hospital moving from high utilization of sliding scale to basal bolus insulin therapy. METHOD: This Retrospective Quality Improvement Study describes the journey of clinicians at a 580-bed hospital to convert from high usage of SSI to BBI. Hyperglycemic adult patients prescribed insulin, with/without a diagnosis of diabetes, were included...
January 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29237288/the-effect-of-continuous-glucose-monitoring-in-preventing-inpatient-hypoglycemia-in-general-wards-the-glucose-telemetry-system
#19
Elias K Spanakis, David L Levitt, Tariq Siddiqui, Lakshmi G Singh, Lillian Pinault, John Sorkin, Guillermo E Umpierrez, Jeffrey C Fink
BACKGROUND: Few studies have examined the use of continuous glucose monitoring (CGM) devices in the general wards. The aim of this pilot study was to examine whether CGM readings can be successfully transmitted from the bedside to a central monitoring device in the nursing station, and whether a glucose telemetry system can prevent hypoglycemic events. METHODS: We present pilot data on 5 consecutive insulin treated general medicine patients with type 2 diabetes (T2DM) whose glucose values were observed with CGM (DEXCOM) and the results were transmitted to a central nursing station monitoring system using DEXCOM Follow and Share 2 software...
January 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#20
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
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