NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Management of Inpatient Hyperglycemia
Evidence-based Synthesis Program
Investigators: Devan Kansagara, MD, Fawn Wolf, MD, Michele Freeman, MPH, and Mark Helfand, MD, MPH.
Author Information and AffiliationsExcerpt
Hyperglycemia is a common finding in hospitalized patients and has been associated with worsened outcomes in a variety of inpatient subpopulations. The use of insulin to control blood glucose has been advocated as a way to improve health outcomes in hospitalized patients with hyperglycemia, but the evidence for the efficacy of this approach and the thresholds for initiating insulin management are unclear. The key questions were: 1. Does strict blood glucose control compared to less strict blood glucose control improve final health outcomes in the following patients: patients in the medical intensive care unit, patients in the surgical intensive care unit, acute myocardial infarction patients, acute stroke patients, post coronary artery bypass graft patients, general surgical ward patients, general medicine ward patients. 2. What are the harms of strict blood glucose control in the above subpopulations? What are the most effective and safest means of normalizing blood glucose in the above subpopulations?
Contents
- PREFACE
- EXECUTIVE SUMMARY
- BACKGROUND
- METHODS
- RESULTS
- Literature Flow
- KEY QUESTION #1. Does strict glycemic control compared to less strict glycemic control improve final health outcomes in the following patients?
- KEY QUESTION #2. What are the harms of strict blood glucose control in the above subpopulations?
- KEY QUESTION #3. What are the most effective and safest means of lowering blood glucose in hospitalized patients?
- SUMMARY AND DISCUSSION
- CONCLUSIONS
- REFERENCES
- APPENDIX A SEARCH STRATEGY
- APPENDIX B INCLUSION/EXCLUSION CRITERIA
- APPENDIX C USPSTF QUALITY RATING CRITERIA
- APPENDIX D REVIEWER COMMENTS AND RESPONSES
- APPENDIX E TABLE OF QUALITY RATINGS
Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Portland Veterans Affairs Healthcare System, Oregon Evidence-based Practice Center, Portland, OR.
- NLM CatalogRelated NLM Catalog Entries
- Intensive insulin protocol implementation and outcomes in the medical and surgical wards at a Veterans Affairs Medical Center.[Ann Pharmacother. 2010]Intensive insulin protocol implementation and outcomes in the medical and surgical wards at a Veterans Affairs Medical Center.Chen HJ, Steinke DT, Karounos DG, Lane MT, Matson AW. Ann Pharmacother. 2010 Feb; 44(2):249-56. Epub 2010 Jan 26.
- Review Blood glucose control in the intensive care unit: benefits and risks.[Semin Dial. 2010]Review Blood glucose control in the intensive care unit: benefits and risks.Gunst J, Van den Berghe G. Semin Dial. 2010 Mar-Apr; 23(2):157-62.
- Evidence for strict inpatient blood glucose control: time to revise glycemic goals in hospitalized patients.[Metabolism. 2008]Evidence for strict inpatient blood glucose control: time to revise glycemic goals in hospitalized patients.Kitabchi AE, Freire AX, Umpierrez GE. Metabolism. 2008 Jan; 57(1):116-20.
- Intensive glucose regulation in hyperglycemic acute coronary syndrome: results of the randomized BIOMarker study to identify the acute risk of a coronary syndrome-2 (BIOMArCS-2) glucose trial.[JAMA Intern Med. 2013]Intensive glucose regulation in hyperglycemic acute coronary syndrome: results of the randomized BIOMarker study to identify the acute risk of a coronary syndrome-2 (BIOMArCS-2) glucose trial.de Mulder M, Umans VA, Cornel JH, van der Zant FM, Stam F, Oemrawsingh RM, Akkerhuis KM, Boersma E. JAMA Intern Med. 2013 Nov 11; 173(20):1896-904.
- Review Anti-inflammatory effects of insulin and pro-inflammatory effects of glucose: relevance to the management of acute myocardial infarction and other acute coronary syndromes.[Rev Cardiovasc Med. 2006]Review Anti-inflammatory effects of insulin and pro-inflammatory effects of glucose: relevance to the management of acute myocardial infarction and other acute coronary syndromes.Dandona P, Chaudhuri A, Ghanim H, Mohanty P. Rev Cardiovasc Med. 2006; 7 Suppl 2:S25-34.
- Management of Inpatient HyperglycemiaManagement of Inpatient Hyperglycemia
Your browsing activity is empty.
Activity recording is turned off.
See more...