The nuts and bolts of subcutaneous insulin therapy in non-critical care hospital settings

Rattan Juneja, Shonda A. Foster, Douglas Whiteman, Jessie L. Fahrbach

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

In non-critical care settings, patients with hyperglycemia experience increased morbidity and mortality. Despite an increased recognition of the importance of treating inpatient hyperglycemia, many patients are still not adequately controlled. Insulin offers flexibility to address varying glucose levels and therefore is the preferred therapy to achieve recommended targets and manage hyperglycemia. Traditional sliding-scale insulin regimens often ineffectively control blood glucose levels as they are unable to mimic physiologic insulin secretion. Basal-bolus insulin regimens are recognized as a more effective way to correct hyperglycemia in non-critical care settings and a systematic glycemic control program is necessary to address hyperglycemia while minimizing hypoglycemia. Critical components of these programs include addressing barriers to glycemic control, understanding varying needs of different types of patients, and developing standardized subcutaneous insulin orders to achieve target glucose levels. This article provides strategies for using insulin in non-critical care settings to facilitate glycemic control.

Original languageEnglish (US)
Pages (from-to)153-162
Number of pages10
JournalPostgraduate Medicine
Volume122
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Basal-bolus
  • Diabetes
  • Glycemic targets
  • Hyperglycemia
  • Inpatient

ASJC Scopus subject areas

  • Medicine(all)

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