Reference Articles and Resources

16. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes—2023 The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes”.

Role of Diabetes Specialists in the Inpatient Setting ADCES 2022

• Management of Diabetes in the Hospital – Umpierrez et al. Lancet 2021
• Management of Hyperglycemic Crises: Diabetic ketoacidosis and hyperglycemic hyperosmolar state (2017)

DKA Protocol from New York Presbyterian Hospital

Inpatient Diabetes Educators Reduce Re-admissions

Hospital Discharge Algorithm 2014 Diabetes Care

Hyperglycemic Crises in Adults with Diabetes » this 2009 article highlights the similar and different characteristics of DKA and HHS. Also included is a discussion on appropriate treatment. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Diabetes care 2009; 32:1335-1343

Hyperglycemic Crises: Diabetic Ketoacidosis (DKA), And Hyperglycemic Hyperosmolar State (HHS) [Updated 2018 May 17]. Gosmanov AR, Gosmanova EO, Kitabchi AE. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279052/

Inpatient hyperglycemia management: A practical review of primary medical and surgical teams – Umpierrez

Management of Inpatient Hyperglycemia and Diabetes in Older Adults – Umpierrez

Management of Hyperglycemia in Hospitalized Patients in the Non-Critical Care Setting: An Endocrine Society Clinical Practice Guideline 2012 » A consensus statement that provides evidence based guidelines on inpatient glucose management for the non critical setting.

Clinical Guidelines for the Management of Hyperglycemia in Hospitalized Patients in a Non-Critical Care Setting » Powerpoint Slide Presentation 2011

Management of Diabetes and Hyperglycemia in Hospitalized-Patients 2014 Endotext-ncbi-bookshelf

Creative Strategies to Improve Diabetes Care in the Inpatient Setting » this article is a guide to setting up an inpatient diabetes program with limited resources and staff. Authored by Beverly Thomassian and based on her experience setting up a diabetes program at Stanford Medical Center.

Consensus Statement on Inpatient Glycemic Control, 2009 » American Association of Clinical Endocrinologists and the American Diabetes Association.

Hospitalization Rates in California – A UCLA Study » This 2014 study reveals that approximately 30% of all hospitalized patients have diabetes.

How to Manage type 2 diabetes in medical and surgical patients in the hospital » A short and straight forward review of the different trials that demonstrate basal /bolus insulin management in the hospital setting improves outcomes.

Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes » One of my favorite articles since it brings attention to the importance of managing hyperglycemia in those not previously diagnosed with diabetes during the hospital stay.

Inpatient Management of Hyperglycemia and Diabetes » this 2011 feature article in Clinical Diabetes by Vasudev Magaji, MD, MS, and Jann M. Johnston, MD from the University of Pittsburgh is practical and includes a basal bolus sample protocol that is clear and easy to use.  Provides a useful framework for initiating inpatient basal bolus therapy.

Management of Inpatient Hyperglycemia in NonCritically Ill Patients » This article provides an excellent overview of the importance of inpatient glucose control and strategies to achieve control in the hospital setting.

RABBIT 2 Trial » Randomized Basal Bolus versus Sliding Scale Regular in Patients with Type 2 Diabetes in the hospital setting.

RABBIT 2 Surgery Trial » Basal-Bolus versus Sliding Scale for Surgical Patient

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Recommended online course

Hospitals and Hyperglycemia Resources

Level 2 – Hospital and Hyperglycemia 1.5 CEs – $29.00

 Research clearly demonstrates the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge.  This course reviews the evidence that supports inpatient glucose control and outline practical strategies to achieve targets in the inpatient setting.  We incorporate the latest ADA Standards and provide links to resources and inpatient management templates. 90-minute course.

Level 4 – Basal Bolus Insulin Therapy in the Hospital Setting 1.5 CEs – $29

Glucose control in the hospital matters! This course provides participants with a step-by-step approach to safely and effectively implement Basal Bolus Insulin Therapy in the inpatient setting. We discuss appropriate insulin dosing based on the patient’s clinical presentation and apply dosing strategies to a variety of case studies. Included are hard-to-manage situations that commonly occur in hospital settings and a discussion of solutions that will keep patients safe and get glucose levels to goal. In addition, sample basal/bolus and insulin drip guidelines plus lots of resource articles are included. This online course is designed for individuals and is also available for institutions. Contact us for more info.

Objectives:

1. Discuss the importance of inpatient glucose control.
2. Describe the goals of care
3. Describe basal bolus insulin therapy
4. Discuss appropriate insulin therapy considerations for a variety of situations.