In this Review, we summarise the evidence from observational studies and clinical trials focusing on inpatient care of people with diabetes and stress hyperglycaemia, including the use of insulin and non-insulin treatment strategies, treatment goals, and the application of new technologies in the hospital setting (Lancet Diabetes & Endocrinology)
Diabetes News
Tag: hyperglycemia
Caring for Hospitalized Patients with Diabetes Mellitus, Hyperglycemia, and COVID-19: Bridging the Remaining Knowledge Gaps
Changes in diabetes-related protocols and new technology can be deployed in the inpatient setting to potentially improve healthcare worker and patient safety; however, one must weigh the risks and benefits of implementation during a pandemic (Current Diabetes Reports)
National Diabetes Audit, Non-Diabetic Hyperglycaemia, 2019- 2020, Diabetes Prevention Programme, Data Release
This short report uses data collected from GP practices alongside the National Diabetes Audit (NDA) for the period January 2019 to March 2020 inclusiv (NHS Digital)
Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes
HHS/DKA occurred mostly in T1D and younger patients. However, both also occurred in T2D, which is of great importance in the treatment of diabetes. Better education programmes are necessary to prevent decompensation and comorbidities (Acta Diabetologica)
Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close
The administration of dipeptidyl peptidase‐4 inhibitors to specific groups of inpatients might be a safe and effective alternative to insulin (Diabetic Medicine)
Hyperglycemia in Medically Critically Ill Patients: Risk Factors and Clinical Outcomes
In our high acuity medically critically ill patient population, achieving time-weighted average daily blood glucose levels <180mg/dl reliably while in the ICU significantly decreased the odds of subsequent hospital mortality. Suboptimal glycemic control during the ICU stay, on the other hand, significantly increased the odds of a longer-than-predicted ICU and hospital stay (American Journal of Medicine)
The impact of hyperglycemia on urinary albumin excretion in recent onset diabetes mellitus type II
Hyperglycemic state emerges as a powerful predictor of increased UAE even at the earliest stages of diabetes. The relative contribution of hypertension and macrovascular dysfunction to the development of microalbuminuria seems to be obscured by hyperglycemia, even in patients whose diabetes onset does not exceed a few months’ time(BMC Nephrology)
Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients
This review covers recommendations for acute management of diabetic ketoacidosis and HHS, the complications associated with these disorders, and methods for preventing recurrence. It also discusses why many patients who present with these disorders are at high risk for hospital readmissions, early morbidity, and mortality well beyond the acute presentation (BMJ)
Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients
This review covers recommendations for acute management of diabetic ketoacidosis and HHS, the complications associated with these disorders, and methods for preventing recurrence. It also discusses why many patients who present with these disorders are at high risk for hospital readmissions, early morbidity, and mortality well beyond the acute presentation (BMJ)
Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Gestational Diabetes Mellitus and Childhood Glucose Metabolism
Offspring exposed to untreated GDM in utero are insulin resistant with limited β-cell compensation compared with offspring of mothers without GDM. GDM is significantly and independently associated with childhood IGT (Diabetes Care)
Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism
Across the maternal glucose spectrum, exposure to higher levels in utero is significantly associated with childhood glucose and insulin resistance independent of maternal and childhood BMI and family history of diabetes (Diabetes Care)
A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes
The Pankowska Equation resulted in reduced postprandial hyperglycaemia at the expense of an increase in hypoglycaemia. There were no significant differences when carbohydrate counting was compared to the Food Insulin Index. Further research is required to optimize prandial insulin dosing (Diabetic Medicine)
Glucose alert system improves health professional responses to adverse glycaemia and reduces the number of hyperglycaemic episodes in non‐critical care inpatients
Use of a novel glucose alert system improved health professional responses to adverse glycaemia and decreased hyperglycaemia in the hospital setting (Diabetic Medicine)
The Pathophysiology of Hyperglycemia in Older Adults: Clinical Considerations
This paper reviews the pathophysiology of type 2 diabetes among older adults and the implications for hyperglycemia management in this population (Diabetes Care)
Management of Hyperglycemia and Diabetes in Orthopedic Surgery
This paper considers the issues surrounding orthopaedic surgery in patients with diabetes and the significance and management of hyperglycemia in the peri-operative period (Current Diabetes Reports)
The identification and treatment of women with hyperglycaemia in pregnancy: an analysis of individual participant data, systematic reviews, meta-analyses and an economic evaluation
Using the national standard cost-effectiveness threshold of £20,000 per QALY it is not cost-effective to routinely identify pregnant women for treatment of hyperglycaemia. Further research to provide evidence on longer-term outcomes, and more cost-effective ways to detect and treat GDM, would be valuable (NIH)
Are There Benefits for Gestational Diabetes Mellitus in Treating Lower Levels of Hyperglycemia Than Standard Recommendations?
These findings suggest a continuous association between adverse outcomes and maternal hyperglycemia and highlight the important role of maternal risk factors other than glycemic results in the development of pregnancy-related complications. Milder forms of hyperglycemia that would not be identified by IADPSG guidelines may benefit from treatment (Canadian Journal of Diabetes)
Association between hyperglycaemia and adverse perinatal outcomes in south Asian and white British women: analysis of data from the Born in Bradford cohort
Our data support the use of lower fasting and post-load glucose thresholds to diagnose gestational diabetes in south Asian than white British women (BMJ)
Hyperglycaemic hyperosmolar syndrome in children: Patient characteristics, diagnostic delays and associated complications
Characteristics of children with HSS are variable for age, gender and BMI-for-age percentile and not predominately limited to obese male adolescent African-American. Delay in diagnosis is common and morbidity and mortality in paediatric HHS are significant (Journal of Paediatrics and Child Health)
Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient
This review discusses the incidence of hyperglycemia, the pathogenesis of hyperglycemia, factors contributing to hyperglycemia in the hospitalized patient, glycemic management goals, current glycemic management recommendations, and considerations for EN formula selection, administration, and treatment (Nutrition in Clinical Practice)
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