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Hyperglycemia in hospital

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https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#1
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28325206/improving-glycemic-control-safely-in-non-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#2
Gregory A Maynard, Diana Childers, Janet Holdych, Heather Kendall, Tom Hoag, Karen Harrison
BACKGROUND: Practice variations in insulin management and glycemic adverse events led nine Dignity Health hospitals to initiate a collaborative effort to improve hypoglycemia, uncontrolled hyperglycemia, and glycemic control. METHODS: Non-critical care adult inpatients with ≥4 point-of-care blood glucose (BG) readings in a ≥2-day period were included. Balanced glucometric goals for each hospital were individualized to improve performance by 10%-20% from baseline or achieve top performance derived from Society of Hospital Medicine (SHM) benchmarking studies...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28323688/challenges-of-inpatient-glycemic-control
#3
Sally O Gerard, Josephine Ritchie
Hyperglycemia occurs in more than 30% of hospitalized patients. The condition has been associated with higher mortality and poor outcomes. Systems to effectively treat dysglycemia have been put into place, although many focus on critical care areas. The purpose of this article is to provide an overview of the challenges for glycemic control in non-critical care areas. Standardized order sets, critical pathways, professional education, and collaborative systems can support improved control.
March 20, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#4
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28302323/new-onset-diabetes-after-acute-and-critical-illness-a-systematic-review
#5
REVIEW
Chirag J Jivanji, Varsha M Asrani, John A Windsor, Maxim S Petrov
Hyperglycemia is commonly observed during acute and critical illness. Recent studies have investigated the risk of developing diabetes after acute and critical illness, but the relationship between degree of in-hospital hyperglycemia and new-onset diabetes has not been investigated. This study examines the evidence for the relationship between in-hospital hyperglycemia and prevalence of new-onset diabetes after acute and critical illness. A literature search was performed of the MEDLINE, EMBASE, and Scopus databases for relevant studies published from January 1, 2000, through August 4, 2016...
March 13, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28298861/retinopathy-of-prematurity-revisiting-incidence-and-risk-factors-from-oman-compared-to-other-countries
#6
Zenaida Soriano Reyes, Sharef Waadallah Al-Mulaabed, Flordeliz Bataclan, Cheryl Montemayor, Anuradha Ganesh, Sanaa Al-Zuhaibi, Huda Al-Waili, Fatma Al-Wahibi
PURPOSE: The purpose of this study is to determine the incidence of retinopathy of prematurity (ROP) and the maternal/neonatal risk factors at a tertiary care hospital in Oman, compared to other countries. PATIENTS AND METHODS: A retrospective analysis of premature neonates born with gestational age (GA) 24-32 weeks at Sultan Qaboos University Hospital, Oman, from January 2007 to December 2010. Maternal and neonatal in-hospital course was retrieved. The incidence of ROP was reported...
January 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28290224/inpatient-continuous-glucose-monitoring-and-glycemic-outcomes
#7
David L Levitt, Kristi D Silver, Elias K Spanakis
Continuous glucose monitoring (CGM) is commonly used in the outpatient setting to improve diabetes management. CGM can provide real-time glucose trends, detecting hyperglycemia and hypoglycemia before the onset of clinical symptoms. In 2011, at the time the Endocrine Society CGM guidelines were published, the society did not recommend inpatient CGM as its efficacy and safety were unknown. While many studies have subsequently evaluated inpatient CGM accuracy and reliability, glycemic outcome studies have not been widely published...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28273059/effect-of-admission-hyperglycemia-on-6-month-functional-outcome-in-patients-with-spontaneous-cerebellar-hemorrhage
#8
Chuanyuan Tao, Xin Hu, Jiajing Wang, Chao You
BACKGROUND Cerebellar hemorrhage (CH) has a quite different treatment strategy and prognostic factors compared with supratentorial intracerebral hemorrhage (ICH). The prognostic role of hyperglycemia has been discussed mainly in cases of supratentorial hemorrhage; it remains to be elucidated following CH. We aimed to determine the association of hyperglycemia on admission with 6-month functional outcome in CH patients. MATERIAL AND METHODS We retrospectively analyzed 77 patients with acute CH between September 2010 and April 2015 in West China Hospital...
March 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28263048/pancreatic-beta-cell-function-is-preserved-in-the-short-term-in-patients-with-type-2-diabetes-undergoing-non-urgent-surgery
#9
Gema Hernanz-Rodriguez, Pablo Pedrianes-Martin, Pedro de Pablos-Velasco, Aurelio Rodriguez-Perez
AIM: Type 2 diabetes mellitus (T2DM) is a progressive condition influences by many factors. Surgery usually produces hyperglycemia in the postoperative period, which leads to adverse clinical outcomes. Possible consequences of surgery on beta cell reserve have not been explored. The aim of this study was to assess the effect of surgery on the beta cell function of patients with T2DM undergoing non-urgent surgery. MATERIALS AND METHODS: We performed a prospective observational study on the population of patients with T2DM scheduled for surgery in a tertiary level hospital...
March 6, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28260772/neonatal-transport-experience-of-a-tertiary-care-hospital-of-bangladesh
#10
S K Dey, S Sharker, I Jahan, S C Moni, K H Shabuj, M J Chisti, M A Mannan, M Shahidullah
Safe transportation is mostly an unnoticed neonatal health issue in Bangladesh and no documentation is available regarding the existing practices. So this study was intended to document transport status of the referred newborn to a tertiary care hospital. This observational study included 150 out born neonates over 12 months period transported from various places to NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU) from May 2015 to April 2016. A structured data collection form was used to record information categorized into pre-transport, during transport and at admission...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28260756/c-reactive-protein-level-in-type-2-diabetic-patients-attending-mymensingh-medical-college-hospital-mymensingh
#11
R Tabassum, A R Mia, K M Reza-Ul-Haq, M Yesmin, J M Faruqui
C-reactive protein (CRP) is a sensitive physiological biomarker of sub-clinical inflammation associated with hyperglycemia, insulin resistance and type 2 diabetic patients. A cross sectional study of 120 subjects attending outpatient department of Mymensingh Medical College, Mymensingh was done with an aim to evaluate serum C-reactive protein in type 2 diabetic patients and compare with age matched non-diabetic persons from July 2014 to June 2015. Of the total cases, 60 were Type 2 diabetic patients and 60 were apparently healthy non-diabetic persons recruited for the study...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28256812/severe-perioperative-hyperglycemia-attenuates-postoperative-monocytic-function-basophil-count-and-t-cell-activation
#12
Gunnar Lachmann, Clarissa von Haefen, Tobias Wollersheim, Claudia Spies
BACKGROUND: Hyperglycemia in hospitalized patients is associated with increased morbidity and mortality. Postoperative infections are particularly common in the setting of preoperative hyperglycemia; however, the relationship between perioperative glucose levels and the innate immune system remains unclear. METHODS: Immune cells, monocytic respectively T cell function and T cell subspecies of 32 patients after esophageal or pancreatic resection were analyzed preoperatively and on the first day after surgery (pod1)...
March 3, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28238331/prognostic-value-of-blood-glucose-in-emergency-room-and-glycosylated-hemoglobin-in-patients-who-have-suffered-an-acute-cerebro-vascular-event
#13
Ander Ernaga Lorea, María Cecilia Hernández Morhain, María Dolores Ollero García-Agulló, Juan Pablo Martínez de Esteban, Ana Iriarte Beroiz, Jaime Gállego Culleré
BACKGROUND AND OBJECTIVE: Stress hyperglycemia has been associated with a worse prognosis in patients hospitalized in critical care units. The aim of this study is to evaluate the impact of blood glucose and glycosylated hemoglobin (HbA1c) levels on the mortality of patients suffering a acute cerebro-vascular event, and to determine if this relationship depends on the presence of diabetes. MATERIAL AND METHODS: A retrospective analysis of 255 patients admitted to the ER for stroke was performed...
February 18, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28238154/the-gestio-protocol-experience-safety-of-a-standardized-order-set-for-subcutaneous-insulin-regimen-in-elderly-hospitalized-patients
#14
Alessandro Franchin, Alberto Maran, Daniela Bruttomesso, Maria L Corradin, Francesco Rossi, Federica Zanatta, Gian-Maria Barbato, Nicola Sicolo, Enzo Manzato
BACKGROUNDS: In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. AIM: To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. METHODS: Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied...
February 25, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28225956/prevalence-of-metabolic-syndrome-in-patients-with-psoriasis-a-hospital-based-cross-sectional-study
#15
Danijela Milčić, Slavenka Janković, Sonja Vesić, Mirjana Milinković, Jelena Marinković, Andja Ćirković, Janko Janković
BACKGROUND: Emerging epidemiological evidence suggests independent associations between psoriasis and metabolic syndrome. Objectives: The aim of the study was to examine the prevalence of metabolic syndrome and its components in patients with psoriasis, and to assess which factors may predict metabolic syndrome in these patients. METHODS: A hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis was conducted at the Clinic of Dermatovenerology, Clinical Center of Serbia, Belgrade, from October 2011 to October 2012...
January 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#16
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
Objective Safely improve glycemic control in the critical care units of nine hospitals. Methods Critical care adult inpatients from nine hospitals with ≥ 4 point-of-care (POC) blood glucose (BG) readings over ≥ 2 days were targeted by collaborative improvement efforts to reduce hyper- and hypo-glycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline, or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care)...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28225312/perspectives-on-learning-and-clinical-practice-improvement-for-diabetes-in-the-hospital-a-review-of-educational-interventions-for-providers
#17
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
BACKGROUND: The management inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning and clinical practice...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224109/timing-method-and-discontinuation-of-hydrocortisone-administration-for-septic-shock-patients
#18
Miguel A Ibarra-Estrada, Quetzalcóatl Chávez-Peña, Claudia I Reynoso-Estrella, Jorge Rios-Zermeño, Pável E Aguilera-González, Miguel A García-Soto, Guadalupe Aguirre-Avalos
AIM: To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS: This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1(st), 2015, to July 31(st), 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28219686/very-high-prevalence-of-frozen-shoulder-in-patients-with-type-1-diabetes-of-more-than-45-years-duration-the-dialong-shoulder-study
#19
Niels Gunnar Juel, Jens Ivar Brox, Cathrine Brunborg, Kristine Bech Holte, Tore Julsrud Berg
OBJECTIVE: To compare the prevalence of shoulder disorders and self-reported shoulder disability in patients with long-term type 1 diabetes mellitus and diabetes-free controls and explore the association between the long-term glycemic burden and shoulder disability in the diabetes group. DESIGN: A cross-sectional study of shoulder diagnoses with 30 years' historical data on glycemic burden in the diabetes patients. SETTING: Questionnaires, interviews and medical records were collected at the Norwegian Diabetics Center (NDC)...
February 17, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28217513/clinical-and-epidemiological-study-of-stress-hyperglycemia-among-medical-intensive-care-unit-patients-in-central-india
#20
Jitendra Sharma, Sachin Chittawar, Ram Singh Maniram, T N Dubey, Ambrish Singh
BACKGROUND: Stress hyperglycemia is common in patients presenting at the emergency medical ward and is associated with poor prognosis and increased risk of mortality. AIMS AND OBJECTIVE: To study and determine the prevalence and factors associated with stress hyperglycemia. MATERIALS AND METHODS: A cross-sectional observational study was performed on 536 nondiabetic patients presented to the Intensive Care Unit (ICU) at Gandhi Medical College and allied Hamidia Hospital, Bhopal, between March 31, 2015, and May 28, 2015...
January 2017: Indian Journal of Endocrinology and Metabolism
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