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Related Concept Videos

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Hospitals provide inpatient and outpatient services. Inpatient services provide care to patients that stay in the hospital for an extended period, ranging from days to months. Examples of inpatient services include intensive care units, hospital wards, or surgeries. Outpatient services provide care to patients who come to a hospital for a diagnostic or treatment but do not stay overnight —for example, diagnostic tests, surgical procedures, or health education.
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Hospitals offer medical and surgical care to the sick and injured, along with accommodation while they recover. At the same time, they also provide outpatient, emergency, psychiatric, and rehabilitation services to meet various community needs. In addition to providing medical care, hospitals also act as hubs for medical research and training. Hospitals use clinical procedures and evidence-based practice standards to deliver patient care. To deliver safe and efficient care, a nurse must stay up...
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Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
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Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
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Complex carbohydrates consumed cannot be absorbed into the small intestine in their original form. First, they must be hydrolyzed to a monosaccharide form such as glucose or galactose. These monosaccharides are then transported across the intestinal membrane and into the blood via transcellular transport. The intestinal epithelial cells allow the movement of these monosaccharides with a defined 'entry' through membrane transporter proteins present on their apical membrane and...
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Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
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Improving IV Insulin Administration in a Community Hospital
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Glucose Management in Hospitalized Patients.

Charles Kodner1, Laurie Anderson1, Katherine Pohlgeers1

  • 1University of Louisville School of Medicine, Louisville, KY, USA.

American Family Physician
|February 13, 2018
PubMed
Summary

Managing blood glucose in hospitalized patients requires careful consideration of targets and medications. Current guidelines suggest a target of 140-180 mg/dL, with safe use of oral diabetes medications like metformin in many cases.

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Area of Science:

  • Internal Medicine
  • Endocrinology
  • Hospital Medicine

Background:

  • Hospitalized patients face challenges in glucose control, impacting wound healing and infection risk.
  • Previous strict glucose targets led to hypoglycemia without improved outcomes.
  • Current recommended blood glucose target is 140-180 mg/dL.

Purpose of the Study:

  • To review current strategies for glucose management in hospitalized patients.
  • To discuss the appropriate use of oral diabetes medications and insulin regimens.
  • To highlight considerations for discharge planning and outpatient follow-up.

Main Methods:

  • Review of current guidelines and evidence regarding inpatient diabetes management.
  • Discussion of the risks and benefits of oral diabetes medications, including metformin.
  • Analysis of insulin dosing strategies, including basal and premeal insulin, and critique of sliding scale insulin.

Main Results:

  • Strict glucose control is not beneficial and increases hypoglycemia risk.
  • Metformin can be safely used in many hospitalized patients with normal renal function.
  • Sliding scale insulin regimens are not recommended due to lack of benefit and increased hypoglycemia risk.

Conclusions:

  • Individualized glucose management is crucial for hospitalized patients.
  • Oral diabetes medications and appropriate insulin regimens can be safely utilized.
  • Effective discharge planning is essential for sustained diabetes control.