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Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
163
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

233
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Updated: Jun 19, 2025

Improving IV Insulin Administration in a Community Hospital
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Inpatient diabetes management.

Andrew P Demidowich1,2,3, Camille Stanback1,2,4, Mihail Zilbermint1,2,5

  • 1Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Annals of the New York Academy of Sciences
|July 25, 2024
PubMed
Summary
This summary is machine-generated.

In-hospital hyperglycemia increases patient risks, necessitating tailored diabetes management strategies. This review covers glycemic targets, insulin, and team-based care for better outcomes.

Keywords:
diabetesdischargehospitalizedinpatientinsulin dosing

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Area of Science:

  • Endocrinology
  • Internal Medicine
  • Hospital Administration

Background:

  • Diabetes mellitus is a growing epidemic, with millions of annual hospital visits and admissions in the US.
  • In-hospital hyperglycemia is linked to increased morbidity, mortality, ICU admissions, and longer hospital stays.
  • Managing diabetes in hospitals is complex, differing significantly from outpatient care due to acute illness and treatments.

Purpose of the Study:

  • To review current concepts and new literature on inpatient diabetes management.
  • To discuss strategies for optimizing glycemic control in hospitalized patients.
  • To highlight the importance of tailored management for patient safety, outcomes, and hospital finances.

Main Methods:

  • This is a review article synthesizing existing research and literature.
  • Core concepts and emerging evidence in inpatient diabetes care are examined.
  • Key areas include glycemic targets, insulin and non-insulin therapies, technology, and care teams.

Main Results:

  • In-hospital hyperglycemia poses significant risks to patient health and hospital resource utilization.
  • Effective management requires individualized glycemic targets and tailored medication strategies.
  • Multidisciplinary teams and robust discharge planning are crucial for continuity of care.

Conclusions:

  • Optimizing inpatient diabetes management is essential for improving patient safety and clinical outcomes.
  • Addressing hyperglycemia proactively can reduce complications and length of stay.
  • Implementing evidence-based strategies and new technologies can enhance care quality and hospital efficiency.