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Published on: June 11, 2012
Glucose control in hospitalized patients
Gregory Sawin1, Allen F Shaughnessy
1Tufts University Family Medicine Residency at Cambridge Health Alliance, 195 Canal St., Malden, MA 02148, USA. gsawin@challiance.org
American Family Physician
|May 4, 2010
Summary
Hospitalized patients with hyperglycemia benefit most from moderate blood glucose control, aiming for less than 180 mg/dL. This approach minimizes risks of hyperglycemia and hypoglycemia without negatively impacting patient outcomes.
Area of Science:
- Internal Medicine
- Endocrinology
- Critical Care
Background:
- Hyperglycemia is common in hospitalized patients.
- Tight blood glucose control in hospitalized patients has not shown clear benefits and may carry risks.
Purpose of the Study:
- To review evidence regarding optimal blood glucose management in hospitalized patients.
- To provide recommendations for managing hyperglycemia in various clinical scenarios.
Main Methods:
- Review of existing literature and clinical guidelines.
- Analysis of patient outcomes related to different blood glucose control strategies.
Main Results:
- Maintaining blood glucose below 180 mg/dL effectively manages hyperglycemia and hypoglycemia without adverse effects.
- Specific medication adjustments are recommended based on patient conditions (e.g., sulfonylureas, thiazolidinediones, metformin).
- Basal-bolus insulin regimens are preferred over sliding-scale insulin for short-term insulin therapy.
Conclusions:
- Moderate blood glucose control (target <180 mg/dL) is recommended for most hospitalized patients.
- Individualized medication management is crucial, considering patient-specific factors and comorbidities.
- Specific protocols for acute myocardial infarction patients emphasize moderate glucose control.
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