18 results on '"Moghissi ES"'
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2. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY--CLINICAL PRACTICE GUIDELINES FOR DEVELOPING A DIABETES MELLITUS COMPREHENSIVE CARE PLAN--2015--EXECUTIVE SUMMARY.
- Author
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Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, Blonde L, Bray GA, Cohen AJ, Dagogo-Jack S, Davidson JA, Einhorn D, Ganda OP, Garber AJ, Garvey WT, Henry RR, Hirsch IB, Horton ES, Hurley DL, Jellinger PS, Jovanovič L, Lebovitz HE, LeRoith D, Levy P, McGill JB, Mechanick JI, Mestman JH, Moghissi ES, Orzeck EA, Pessah-Pollack R, Rosenblit PD, Vinik AI, Wyne K, and Zangeneh F
- Subjects
- Humans, Comprehensive Health Care, Diabetes Mellitus therapy
- Published
- 2015
3. Hyperglycemia grand rounds: descriptive findings of outcomes from a continuing education intervention to improve glycemic control and prevent hypoglycemia in the hospital setting.
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Moghissi ES, Inzucchi SE, Mann KV, Byerly B, Ermentrout L, Juchniewicz JJ, Ferareza JH, and Kirkwood N
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- Attitude of Health Personnel, Humans, Medical Staff, Hospital standards, Quality Improvement organization & administration, United States, Clinical Competence standards, Education, Medical, Continuing organization & administration, Hyperglycemia prevention & control, Hypoglycemia prevention & control, Medical Staff, Hospital education
- Abstract
Unlabelled: Hyperglycemia is common in the hospital in-patient setting and is associated with adverse outcomes. Healthcare professionals (HCPs) often fail to use best practices established to manage this condition or to coordinate care among team members., Objectives: The objective of the Hyperglycemia Grand Rounds (HGR) continuing education initiative was to improve knowledge levels in a team setting, leading to improved clinical competence, evidence-based behaviors, and improved patient care., Methods: To achieve that goal, a four-module seminar series was presented to HCPs on-site in a "Grand Rounds" format at healthcare institutions across the United States. Outcomes data included satisfaction, learning, impact, and intent-to-implement measures at event time and at follow-up. At the site level, detailed questionnaires assessed skill gaps and expected outcomes from administrators at the time the modules were scheduled and the impact after modules were completed. Demographic information allowed identification of HCPs receiving maximum benefits; data on barriers to implementation are reported., Results: Seventy-eight percent of participants self-reported a positive impact on competence, performance, or patient outcomes. Forty percent of learners said they intended to make specific changes in practices. Eighty-two percent of administrators confirmed expected changes in their health system. The follow-up study concurred with the initial findings., Conclusion: The HGR was an effective program in improving self-reported competence amongst attendees that could potentially lead to improved care. This descriptive report summarizes outcomes from 1 year of educational efforts to more than 2000 healthcare professionals.
- Published
- 2015
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4. Treating patients with diabetes of long duration: GLP-1 receptor agonists and insulin in combination.
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Moghissi ES
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- Blood Glucose drug effects, Diabetes Mellitus, Type 2 blood, Drug Therapy, Combination, Glucagon-Like Peptide-1 Receptor, Glycated Hemoglobin metabolism, Humans, Receptors, Glucagon blood, Time Factors, Treatment Outcome, Blood Glucose metabolism, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Receptors, Glucagon agonists
- Abstract
Patients with long-standing type 2 diabetes mellitus (T2DM) can be clinically challenging for physicians to treat because these patients often lack sufficient β-cell function to respond to some oral glucose-lowering agents, may have profound comorbidities, and may have renal impairment that limits the use of traditional agents. These complications, in addition to older age, also increase the risk of hypoglycemia, which can be a major barrier to treatment success. Individualizing treatment targets to balance the benefits of glycemic control with risks of hypoglycemia is the first step to successfully treating these patients. Careful selection of combination therapy strategies to address limited β-cell function, renal function, and cardiovascular status, along with attention to selection of agents associated with lower risk of hypoglycemia, is important. Basal insulin analogs are often used in patients with long-standing diabetes to address insulinopenic states. Incretin-based therapies, particularly GLP-1 receptor agonists, provide postprandial control with lower risks of hypoglycemia than prandial insulin. The author discusses the management of patients with long-standing diabetes who may have limited β-cell function and require transition to insulin therapy with gradual intensification.
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- 2014
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5. Pathways to quality inpatient management of hyperglycemia and diabetes: a call to action.
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Draznin B, Gilden J, Golden SH, Inzucchi SE, Baldwin D, Bode BW, Boord JB, Braithwaite SS, Cagliero E, Dungan KM, Falciglia M, Figaro MK, Hirsch IB, Klonoff D, Korytkowski MT, Kosiborod M, Lien LF, Magee MF, Masharani U, Maynard G, McDonnell ME, Moghissi ES, Rasouli N, Rubin DJ, Rushakoff RJ, Sadhu AR, Schwartz S, Seley JJ, Umpierrez GE, Vigersky RA, Low CC, and Wexler DJ
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- Adult, Blood Glucose drug effects, Diabetes Mellitus drug therapy, Humans, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Inpatients, Diabetes Mellitus blood, Hyperglycemia blood
- Abstract
Currently patients with diabetes comprise up to 25-30% of the census of adult wards and critical care units in our hospitals. Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) is beneficial for positive outcomes in the hospitalized patient, much of this evidence remains controversial and at times somewhat contradictory. We have recently formed a consortium for Planning Research in Inpatient Diabetes (PRIDE) with the goal of promoting clinical research in the area of management of hyperglycemia and diabetes in the hospital. In this article, we outline eight aspects of inpatient glucose management in which randomized clinical trials are needed. We refer to four as system-based issues and four as patient-based issues. We urge further progress in the science of inpatient diabetes management. We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.
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- 2013
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6. American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for developing a diabetes mellitus comprehensive care plan: executive summary.
- Author
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Handelsman Y, Mechanick JI, Blonde L, Grunberger G, Bloomgarden ZT, Bray GA, Dagogo-Jack S, Davidson JA, Einhorn D, Ganda O, Garber AJ, Hirsch IB, Horton ES, Ismail-Beigi F, Jellinger PS, Jones KL, Jovanovič L, Lebovitz H, Levy P, Moghissi ES, Orzeck EA, Vinik AI, and Wyne KL
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- Humans, United States, Comprehensive Health Care standards, Diabetes Mellitus, Societies, Medical standards
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- 2011
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7. Statement by the American Association of Clinical Endocrinologists Consensus Panel on insulin pump management.
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Grunberger G, Bailey TS, Cohen AJ, Flood TM, Handelsman Y, Hellman R, Jovanovič L, Moghissi ES, and Orzeck EA
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- Diabetes Mellitus blood, Diabetes Mellitus drug therapy, Endocrinology instrumentation, Endocrinology methods, Expert Testimony, Health Personnel, Humans, Hypoglycemic Agents administration & dosage, Infusions, Subcutaneous, Insulin administration & dosage, Meta-Analysis as Topic, Models, Biological, United States, Consensus, Endocrinology organization & administration, Insulin Infusion Systems statistics & numerical data, Societies, Medical organization & administration
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- 2010
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8. Reexamining the evidence for inpatient glucose control: new recommendations for glycemic targets.
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Moghissi ES
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- Humans, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Treatment Outcome, Blood Glucose analysis, Glycemic Index, Inpatients, Practice Guidelines as Topic
- Abstract
Purpose: To review the risks of hyperglycemia in hospitalized patients, data supporting the benefits of treating hyperglycemia, and recommendations from the 2009 American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on the management of inpatient hyperglycemia., Summary: Inpatient hyperglycemia is common, costly, and associated with poor clinical outcomes in many disease states. Despite inconsistencies in clinical trial results, good glucose management in the hospital remains important. Target blood glucose concentrations (BGs) were recently modified to somewhat higher values with the expectation that the benefit of treatment will persist with a lower risk of hypoglycemia, which is itself another marker of poor outcome in critically and non-critically ill patients. In the intensive care unit (ICU), the threshold to start treatment is a BG of
180 mg/dL are no longer recommended. In non-critically ill patients, premeal BG targets are <140 mg/dL; random BGs of <180 mg/dL are recommended. Scheduled subcutaneous insulin is the treatment of choice for hyperglycemia in non-critically ill patients; use of sliding-scale insulin is strongly discouraged. To avoid hypoglycemia, insulin regimens should be reassessed if BG falls to <100 mg/dL., Conclusion: Poor glycemic control in the hospital setting is a quality-of-care, safety, and cost issue. Safe and effective strategies to implement optimal glycemic control require multidisciplinary involvement. Insulin given i.v. in the ICU or subcutaneously on an as-scheduled regimen in other parts of the hospital is the treatment of choice. - Published
- 2010
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9. Addressing hyperglycemia from hospital admission to discharge.
- Author
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Moghissi ES
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- Humans, Hyperglycemia blood, Hypoglycemic Agents adverse effects, Insulin adverse effects, Hospitalization, Hyperglycemia therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Monitoring, Physiologic methods, Patient Discharge
- Abstract
Background: This review examines glycemia management practices in hospitalized patients. Optimal glycemic control remains a challenge among hospitalized patients. Recent studies have questioned the benefit of tight glycemic control and have raised concerns regarding the safety of this approach. As a result, medical societies have updated glycemic targets and have published new consensus guidelines for management of glycemia in hospitalized patients. This review highlights recent inpatient glycemic trials, the new glycemic targets and recommended strategies for management of glycemia in hospitalized patients., Methods: Medline and PubMed searches (diabetes, hyperglycemia, hypoglycemia, intensive therapy insulin, tight glycemic control, and hospital patients) were performed for English-language articles on treatment of diabetes, insulin therapy, hyperglycemia or hypoglycemia in hospitalized patients published from 2004 to present. Earlier works cited in these papers were surveyed. Clinical studies, reviews, consensus/guidelines statements, and meta-analyses relevant to the identification and management of diabetes and hyperglycemia in hospitalized patients were included and selected. This is not an exhaustive review of the published literature., Results: Insulin remains the most appropriate agent for a majority of hospitalized patients. In critically ill patients insulin is given as a continuous intravenous (IV) infusion and in non-critically ill inpatients hyperglycemia is best managed using scheduled subcutaneous (SC) basal-bolus insulin regimens supplemented with correction doses as needed and adjusted daily with the guidance of frequent blood glucose monitoring. Prevention of hypoglycemia is equally as important to patient outcomes and is an equally necessary part of any effective glucose control program. Modern insulin analogs offer advantages over the older human insulins (e.g., regular and neutral protamine Hagedorn [NPH] insulin) because their time-action profiles more closely correspond to physiological basal and prandial insulin requirements, and have a lower propensity for inducing hypoglycemia than human insulin formulations. Long-acting basal insulin analogs (glargine, detemir) are suitable and preferred for the basal component of therapy; rapid-acting insulin analogs (aspart, lispro, glulisine) are recommended for bolus and correction doses. Sliding-scale insulin (SSI) regimens are not effective and should not be used, especially as this excludes a basal insulin component from the therapy., Conclusions: Optimal glycemic management in the hospital setting requires judicious treatment of hyperglycemia while avoiding hypoglycemia. Insulin is the most appropriate agent for management of hyperglycemia for the majority of hospitalized patients. Intravenous insulin infusion is still preferred during and immediately after surgery, but s.c. basal insulin analogs with prandial or correction doses should be used after the immediate post-operative period, and also should be used in non-critically ill patients. Frequent and effective glucose monitoring is critical for avoiding wide deviations from acceptable glucose levels, which under a recently promulgated consensus guideline currently range between 140 mg/dL and 180 mg/dL. Glucose targets near 140 mg/dL are recommended as being the most appropriate for all hospitalized patients.
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- 2010
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10. Comparisons of different insulin infusion protocols: a review of recent literature.
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Krikorian A, Ismail-Beigi F, and Moghissi ES
- Subjects
- Algorithms, Blood Glucose metabolism, Clinical Protocols, Critical Illness, Humans, Infusions, Intravenous, Critical Care methods, Hyperglycemia drug therapy, Hypoglycemic Agents administration & dosage, Insulin administration & dosage
- Abstract
Purpose of Review: To provide an update on the currently available insulin infusion protocols for treatment of hyperglycemia in critically ill patients and to discuss the major differences and similarities among them., Recent Findings: We identified a total of 26 protocols, 20 of which used manual blood-glucose calculations, and six that used computerized algorithms. The major differences and similarities among the insulin infusion protocols were in the following areas: patient characteristics, target glucose level, time to achieve target glucose level, incidence of hypoglycemia, rationale for adjusting the rates of insulin infusion, and methods of blood-glucose measurements. Several computerized protocols hold promise for safer achievement of glycemic targets., Summary: Insulin infusion is the most effective method for controlling hyperglycemia in critically ill patients. Clinicians should utilize a validated insulin infusion protocol that is well tolerated, and is most appropriate and practical for their institution based on the resources that are available.
- Published
- 2010
- Full Text
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11. Statement by an American Association of Clinical Endocrinologists/American College of Endocrinology consensus panel on type 2 diabetes mellitus: an algorithm for glycemic control.
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Rodbard HW, Jellinger PS, Davidson JA, Einhorn D, Garber AJ, Grunberger G, Handelsman Y, Horton ES, Lebovitz H, Levy P, Moghissi ES, and Schwartz SS
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- Adult, Aged, Algorithms, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 physiopathology, Drug Therapy, Combination, Humans, Hyperglycemia drug therapy, Hyperglycemia prevention & control, Hypoglycemia prevention & control, Hypoglycemic Agents adverse effects, Hypoglycemic Agents pharmacology, Middle Aged, Risk Assessment, Young Adult, Blood Glucose analysis, Diabetes Mellitus, Type 2 drug therapy, Glycated Hemoglobin analysis, Hypoglycemic Agents therapeutic use
- Abstract
This report presents an algorithm to assist primary care physicians, endocrinologists, and others in the management of adult, nonpregnant patients with type 2 diabetes mellitus. In order to minimize the risk of diabetes-related complications, the goal of therapy is to achieve a hemoglobin A1c (A1C) of 6.5% or less, with recognition of the need for individualization to minimize the risks of hypoglycemia. We provide therapeutic pathways stratified on the basis of current levels of A1C, whether the patient is receiving treatment or is drug naïve. We consider monotherapy, dual therapy, and triple therapy, including 8 major classes of medications (biguanides, dipeptidyl-peptidase-4 inhibitors, incretin mimetics, thiazolidinediones, alpha-glucosidase inhibitors, sulfonylureas, meglitinides, and bile acid sequestrants) and insulin therapy (basal, premixed, and multiple daily injections), with or without orally administered medications. We prioritize choices of medications according to safety, risk of hypoglycemia, efficacy, simplicity, anticipated degree of patient adherence, and cost of medications. We recommend only combinations of medications approved by the US Food and Drug Administration that provide complementary mechanisms of action. It is essential to monitor therapy with A1C and self-monitoring of blood glucose and to adjust or advance therapy frequently (every 2 to 3 months) if the appropriate goal for each patient has not been achieved. We provide a flow-chart and table summarizing the major considerations. This algorithm represents a consensus of 14 highly experienced clinicians, clinical researchers, practitioners, and academicians and is based on the American Association of Clinical Endocrinologists/American College of Endocrinology Diabetes Guidelines and the recent medical literature.
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- 2009
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12. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control.
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Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, Inzucchi SE, Ismail-Beigi F, Kirkman MS, and Umpierrez GE
- Subjects
- Blood Glucose analysis, Consensus Development Conferences as Topic, Diabetes Mellitus economics, Endocrinology standards, Humans, Hyperglycemia economics, Hyperglycemia ethnology, Societies, Medical standards, Blood Glucose metabolism, Diabetes Mellitus blood, Inpatients statistics & numerical data
- Published
- 2009
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13. Insulin strategies for managing inpatient and outpatient hyperglycemia and diabetes.
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Moghissi ES
- Subjects
- Ambulatory Care methods, Blood Glucose metabolism, Diabetes Mellitus blood, Drug Monitoring methods, Hospitalization, Humans, Hyperglycemia blood, Infusions, Intravenous, Injections, Subcutaneous, Patient Selection, Preoperative Care methods, Treatment Outcome, Diabetes Mellitus drug therapy, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use
- Abstract
Optimal fasting and postprandial glycemic control are essential to limiting microvascular and macrovascular complications associated with diabetes. Recently, stringent control of hyperglycemia in critically ill hospitalized patients with diabetes or acute hyperglycemia has been shown to reduce the risk of morbidity and mortality. This article reviews effective strategies for insulin initiation, titration, and intensification in inpatient and outpatient settings and discusses current treatment strategies when patients are being transitioned from the intensive care unit to general wards and discharged. The development of insulin analogs and premixed insulin analogs has created new options for treating inpatients and outpatients. The more physiologic time-action profiles, improved insulin delivery systems, and standardized protocols for subcutaneous insulin administration and intravenous insulin infusion have improved the safety and convenience of insulin therapy.
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- 2008
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14. Diagnosis and management of prediabetes in the continuum of hyperglycemia: when do the risks of diabetes begin? A consensus statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists.
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Garber AJ, Handelsman Y, Einhorn D, Bergman DA, Bloomgarden ZT, Fonseca V, Garvey WT, Gavin JR 3rd, Grunberger G, Horton ES, Jellinger PS, Jones KL, Lebovitz H, Levy P, McGuire DK, Moghissi ES, and Nesto RW
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- Diabetes Mellitus epidemiology, Humans, Risk Factors, Diabetes Mellitus prevention & control, Hyperglycemia prevention & control, Prediabetic State diagnosis, Prediabetic State therapy
- Published
- 2008
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15. Glycemia management and cardiovascular risk in type 2 diabetes: an evolving perspective.
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Ismail-Beigi F and Moghissi ES
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- Blood Glucose metabolism, Cardiovascular Diseases blood, Cardiovascular Diseases etiology, Cardiovascular Diseases prevention & control, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Glycated Hemoglobin metabolism, Humans, Risk Factors, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Objective: To review recent glycemia trials focused on reducing cardiovascular disease (CVD) risk in patients with type 2 diabetes and to describe how the results of these studies have altered our approach to the management of glycemia in patients with diabetes., Methods: Results of some of the previous as well as recent trials, including the Action to Control Cardiovascular Risk in Diabetes (ACCORD), Action in Diabetes and Vascular Disease (ADVANCE), and Veterans Affairs Diabetes Trial (VADT), are reviewed., Results: The results demonstrate that the establishment of glycemia (hemoglobin A1c) goals in patients with type 2 diabetes aimed at reducing CVD events is complex, should be highly individualized, and should probably be varied depending on the duration of diabetes as well as the presence or absence of CVD and microvascular complications., Conclusion: Results of the ACCORD, ADVANCE, and VADT studies have considerably increased our knowledge and refined our approach to establishing glycemia goals in patients with type 2 diabetes. In patients with recently recognized diabetes with no prior CVD events, glycemic control to normal or near-normal levels appears to be effective in preventing CVD events and mortality. In patients with established diabetes (8 to 10 or more years) and recognized CVD, however, glycemic control to normal or near-normal levels does not reduce the risk of further CVD events or mortality. Importantly, strict control of all known risk factors for CVD and microvascular complications by aggressive management of hypertension, dyslipidemia, and glycemia, use of aspirin, and cessation of smoking in patients with type 2 diabetes has proved to be highly beneficial.
- Published
- 2008
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16. Insulin infusion protocols for critically ill patients: a highlight of differences and similarities.
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Nazer LH, Chow SL, and Moghissi ES
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- Controlled Clinical Trials as Topic, Databases, Bibliographic, Humans, Hypoglycemia drug therapy, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents therapeutic use, Insulin administration & dosage, MEDLINE, Critical Illness therapy, Insulin therapeutic use, Insulin Infusion Systems
- Abstract
Objective: To discuss the major differences and similarities among the currently published insulin infusion protocols (IIPs) for critically ill patients., Methods: IIPs were identified by searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. The reference lists for all retrieved protocols were also reviewed to identify any IIPs that were not surfaced with use of our initial search strategies. The major differences and similarities among the IIPs were identified and examined. In addition, strategies for successful implementation of IIPs were outlined., Results: Our search strategies retrieved 17 IIPs. Currently, no published studies have compared one insulin protocol with another. The major differences or similarities among the published IIPs were in the following areas: patient characteristics, target glucose level, time to achieve target glucose level, incidence of hypoglycemia, rationale for adjusting the rates of insulin infusion, and methods of blood glucose measurements. Because of variations in the definition of hypoglycemia, methods of blood glucose measurement, and types of blood samples used, some comparisons across the protocols were difficult. Use of a multidisciplinary team and gaining administrative support are crucial for addressing issues and provision of necessary resources for implementing a protocol for "tight" glycemic control in critically ill patients., Conclusion: Clinicians should evaluate the type of patients in their critical care units, the mean baseline glucose levels, and the available resources to determine the most appropriate and practical IIP for their institution.
- Published
- 2007
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17. Hospital management of diabetes.
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Moghissi ES and Hirsch IB
- Subjects
- Algorithms, Cardiovascular Diseases, Coronary Artery Bypass, Humans, Inpatients, Diabetes Mellitus drug therapy, Hospitalization, Hyperglycemia drug therapy, Insulin therapeutic use
- Abstract
The evidence continues to strengthen our understanding that improved glycemic control with the use of insulin therapy may significantly improve morbidity and mortality in hospitalized patients with hyperglycemia, with or without a previous diagnosis of diabetes. However, many questions remain concerning the impact and relative contributions of blood glucose and insulin per se. Nevertheless, the publication of numerous and consistent studies have made it clear that the topic of glycemic management in the hospital requires a larger priority among clinicians caring for these patients. The recently published guidelines by the American Association of Clinical Endocrinologists are the first formal recommendations on this topic,but national guidelines for blood glucose levels cannot take into account all of the different challenges facing different hospitals. This suggests that each institution will require individualization of protocols even though the ultimate metabolic goals are identical. Furthermore, it is not realistic to expect those unfamiliar with diabetes therapy to appreciate all of the nuances and vagaries of insulin treatment. Like any medical treatment, a significant amount of time will need to be invested by the providers involved with the.care of these patients before a mastery of the therapy can be achieved. Nevertheless, because the rewards to our patients can be significant, we need to strive to improve the systems where we work. Individual clinicians with vast experience in diabetes care cannot be successful for the inpatient with diabetes unless the hospital has systems in place to effectively and efficiently facilitate the management of the metabolic needs of this population. The main challenge now is the safe and effective implementation of these guidelines in both small and large hospitals given the limited level of re-sources available in today's medical environment. Therefore, our single most important recommendation is to ensure that all clinicians involved in the management of these patients are in agreement about general philosophies of diabetes management. We would recommend that there are "champions" for each discipline: endocrinology, cardiology, anesthesiology, surgery, nursing,and pharmacy, all of which have developed hospital-specific guidelines for glycemic management. These recommendations can be slowly adapted, one unit at a time, until the entire hospital has transitioned to a more "diabetes-friendly" environment. The ultimate goal of well-controlled glycemia with minimal hypoglycemia should be possible for most hospitals, and we hope this review will assist clinicians in achieving this objective. We await additional outcome research with carefully controlled studies to confirm the value of these recommendations at different levels of glycemic control. We believe that we can already state with confidence that the preliminary evidence shows that, like outpatient diabetes management,metabolic control matters during acute illness.
- Published
- 2005
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18. American College of Endocrinology position statement on inpatient diabetes and metabolic control.
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Garber AJ, Moghissi ES, Bransome ED Jr, Clark NG, Clement S, Cobin RH, Furnary AP, Hirsch IB, Levy P, Roberts R, Van den Berghe G, and Zamudio V
- Subjects
- Blood Glucose analysis, Blood Glucose immunology, Cardiovascular Diseases immunology, Cardiovascular Diseases physiopathology, Diabetes Complications, Diabetes Mellitus immunology, Diabetes Mellitus physiopathology, Female, Hospitalization, Humans, Hyperglycemia etiology, Hyperglycemia immunology, Hyperglycemia physiopathology, Hypoglycemic Agents therapeutic use, Inpatients, Insulin therapeutic use, Male, Pregnancy, Treatment Outcome, Diabetes Mellitus drug therapy, Hyperglycemia drug therapy
- Published
- 2004
- Full Text
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