Hyperglycemia, one of the most common and serious health problems among hospitalized clients, increases an individual’s risk to life-threatening complications. This condition affects even non-diabetic hospitalized clients. Characterized with a high blood sugar level, this health problem affects around 32 to 38% of inpatient individuals in community hospitals based on an observational study. Advancement of the measures that will control serum glucose (blood sugar) levels will definitely lower client mortality from hospital complications in both general medicine and surgical departments.
A new clinical practice guidelines (CPG) was released recently by the Endocrine Society. The set of standards will be release to provide safe and practical recommendations on achieving a healthy glycemic goal for clients cared for in non-critical areas. CPG offered a protocol on checking the blood sugar levels of all clients, regardless of being treated with diabetes or not. The set of standard of would go public on February 2012 on the issue: Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society. The CPG by then will be officially called ‘Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Setting: An Endocrine Society Clinical Practice Guideline.’
The key person in writing the CPG, Guillermo Umpierrez, MD explained how hyperglycemia has been linked to prolonged hospital stay. The guideline recommends experts to promote the goal of decreasing mortality from complications of hyperglycemia in non-critical care settings which includes the following recommendations:
- Clients with non-critical illness glycemic targets should be given a pre-meal glucose target of less than 140 mg/dl. The rate of random blood glucose should also be less than 180 mg/dl.
- On admission, clients with high blood sugar levels and those who are receiving nutrition via intravenous or feeding tubes, with or without diabetes history, needs to receive bedside glucose test.
- Diabetic clients receiving regular insulin at home are to be given scheduled insulin administered subcutaneously throughout the hospital stay.
- Surgical clients with Type 1 and 2 diabetes are to be given a continuous insulin infusion (IV) or with bolus insulin when necessary subcutaneously. This prevents episodes of hyperglycemia during the perioperative period.
- One to two hours before discontinuing the continuous insulin infusion (IV), patients with type 1 and 2 diabetes should be given subcutaneous insulin therapy. This provides a smooth transition to insulin discontinuation.
Detailed explanation about the causes and impacts of hyperglycemia are found on various resources online. The Endocrine Society also affiliated with The Hormone Foundation to provide better public education on CPG guide. Furthermore the patient guide which can be found online, enumerates expert recommendations on treatment options.
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