Postgraduate medicine
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Postgraduate medicine · Nov 2008
ReviewHyperglycemia management in the hospital: about glucose targets and process improvements.
Hyperglycemia is prevalent in the inpatient setting and is associated with increased morbidity and mortality in patients with and without diabetes. Too often hyperglycemia is underrecognized, underreported, and suboptimally managed. Proactive assessment of inpatients' glycemic status and aggressive treatment approaches are needed. ⋯ Consequently, the question is whether tight glycemic control strategies should focus on achieving tight glycemic targets with early and intensive insulin therapy, on process improvements aimed at optimal and safe insulin delivery, or a combination of both approaches. The relative importance of each approach must be carefully balanced by integrated health care teams within each institution. If hyperglycemia management is championed from admission through discharge, patients could experience improved outcomes and institutions could achieve substantial health care cost savings.