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Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Inpatient Diabetes Management in Special Populations (Elderly, Cystic Fibrosis, Pregnancy, Chronic Kidney Disease,
1Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA.
Diabetes management in certain patient populations has unique challenges and goals. Among these populations are pregnant people, elderly people, and people with chronic kidney disease, cystic fibrosis, or liver dysfunction. In pregnancy, insulin resistance increases weekly during the second and third trimesters and rapidly decreases with delivery. Diabetes in elderly patients is complicated by polypharmacy, declining cognitive and functional status, and higher risk of morbidity and mortality from hypoglycemia. Patients with cystic fibrosis-related diabetes are at higher risk of mortality than those without diabetes. Patients with liver dysfunction have risk factors for hypoglycemia although no specific guidelines for management exist.
Diabetes management in certain patient populations has unique challenges and goals. Among these populations are pregnant people, elderly people, and people with chronic kidney disease, cystic fibrosis, or liver dysfunction. In pregnancy, insulin resistance increases weekly during the second and third trimesters and rapidly decreases with delivery. Diabetes in elderly patients is complicated by polypharmacy, declining cognitive and functional status, and higher risk of morbidity and mortality from hypoglycemia. Patients with cystic fibrosis-related diabetes are at higher risk of mortality than those without diabetes. Patients with liver dysfunction have risk factors for hypoglycemia although no specific guidelines for management exist.
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