Managing Glucose in the Hospital: The Need for Consistency
February 06, 2007
Digg This! | Send to Newsvine | Add to del.icio.usFebruary 6, 2007 (ADA) - Studies show that when people with diabetes are admitted into the hospital for serious illnesses, they are more likely to survive if their glucose levels are kept under tight control.
But maintaining proper glucose targets isn’t that simple, according to a paper by the research team led by Dr. Kathleen Dungan at the University of North Carolina at Chapel Hill. Numerous variables can make it difficult to determine if the patient is actually meeting optimal glucose targets. For example, where blood is taken from and the instrument used to measure glucose levels can produce substantially different results. Medications can also obscure proper blood glucose readings, along with the patient’s physiology.
“Nowhere else is there greater potential for multiple confounding factors to be present at once than in the hospital setting,” wrote the authors, in the paper’s conclusions. Because of this, the researchers advise that glucose targets be individualized for each health care setting, taking into account how measurements will be taken and the needs of specific patient populations.
Posted by dlife at February 6, 2007 11:38 AM
Comments
I was admitted to the hospital for intervention radiology. I needed to have a pulmonary arteriovenus malformation repaired. (it is like an anurisum between an artery and a vein). It was a one day procedure that used the same instruments as an angiogram, with springs inserted into my lung with a cathater inserted in my groin. I couldn't take my metformin because of the dye used. The nurse took my glucose level when I arrived. After the procedure, I wanted lunch. I could eat right away because no sedation was used. The nurse brought me a lunch with more than 85 carbs! Even chips! She appologized for forgetting to bring the jam and asked if I wanted sugar for my coffee. They never checked my blood sugar again while I was there. It was 264 in the afternoon when I checked it. They also gave me no written notice on when to start my metformin again. They also didn't set me up or mention the bloodwork needed before I could start my medication again. Good thing that I wasn't sedated and was paying attention!
Posted by: Jennifer at February 11, 2007 09:54 PM
This is very true. I was admitted to the hospital with a very bad pneumonia and my glucose level tripled! They kept sending me "Regular" food trays even after I told the RD that I do not eat that type of a diet.
I had to go to the Joslin center in my area afterwards to get my glucose under control. I thought that I was going to die.
Posted by: Bill C at February 9, 2007 04:47 PM
Right On!
EVERY patient admitted to a hospital should be fitted with a wireless Continuous Glucose Monitor.
Identifying unsuspected diabetes, sugar changes resulting from trauma, meds, etc., and better, faster healing are proven outcomes.
Properly applied, this practice is truly cost effective.
All this leads to not only better practice but overall less cost and possibly less liability.
I hope the insurance companies are listening.
Posted by: Albert P. Kretz, Ph.D., MBA at February 9, 2007 02:05 PM