Glucose Testing Suggested for All Inpatients

The guidelines also address transition from intravenous to subcutaneous insulin therapy, glycemic management of patients who are receiving enteral or parenteral nutrition, perioperative blood glucose control, and management of glucocorticoid-induced diabetes.

<[stk -3]>The panel recommended the development of protocols with specific directions for avoiding and managing hypoglycemia as well as the implementation of hospital-wide, nurse-initiated hypoglycemia treatment protocols and a system for tracking with root cause analysis the frequency of hypoglycemic events. The document lists key components of such protocols, and provides suggested nurse-initiated strategies.<[etk]>

<[stk -3]>Hospitals are advised to provide administrative support for an interdisciplinary steering committee targeting a systems approach to improve care of inpatients with hyperglycemia and diabetes. Uniform methods for collecting and evaluating point-of-care testing data and insulin use information in hospitals are recommended, as are the provision of accurate devices for glucose measurement at the bedside with ongoing staff education and competency assessments.

Dr. Hellman and Dr. Umpierrez have no financial disclosures, but three other members of the guideline panel declared relationships with manufacturers of diabetes-related products.