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Erschienen in: Current Diabetes Reports 2/2014

01.02.2014 | Hospital Management of Diabetes (G Umpierrez, Section Editor)

Management of Patients with Type 1 Diabetes in the Hospital

verfasst von: Divya Yogi-Morren, M. Cecilia Lansang

Erschienen in: Current Diabetes Reports | Ausgabe 2/2014

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Abstract

Managing a patient with type 1 diabetes mellitus can be challenging to the inpatient medical team. These patients require a continuous supply of exogenous insulin, and the omission of even a single dose can result in severe hyperglycemia and diabetic ketoacidosis. This article aims to equip the inpatient medical team with the knowledge and expertise required to care for these patients in the hospital, including transitioning from home to hospital, transitioning from the intravenous insulin infusion to the subcutaneous route, subcutaneous insulin dosing including the insulin pump, and transitioning back to home.
Literatur
2.
Zurück zum Zitat Onkamo P, Väänänen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes—the analysis of the data on published incidence trends. Diabetologia. 1999;42:1395–403.PubMedCrossRef Onkamo P, Väänänen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes—the analysis of the data on published incidence trends. Diabetologia. 1999;42:1395–403.PubMedCrossRef
3.
Zurück zum Zitat Devendra D, Liu E, Eisenbarth GS. Type 1 diabetes: recent developments. BMJ. 2004;328:750–4.PubMedCrossRef Devendra D, Liu E, Eisenbarth GS. Type 1 diabetes: recent developments. BMJ. 2004;328:750–4.PubMedCrossRef
4.
Zurück zum Zitat Lambert AP, Gillespie KM, Thomson G, et al. Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab. 2004;89:4037–43.PubMedCrossRef Lambert AP, Gillespie KM, Thomson G, et al. Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab. 2004;89:4037–43.PubMedCrossRef
5.
Zurück zum Zitat Umpierrez GE, Isaacs SD, Bazargan N, You X, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–82.PubMed Umpierrez GE, Isaacs SD, Bazargan N, You X, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–82.PubMed
6.
Zurück zum Zitat Zerr KJ, Furnary AP, Grunkemeier GL, et al. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–61.PubMedCrossRef Zerr KJ, Furnary AP, Grunkemeier GL, et al. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–61.PubMedCrossRef
7.
Zurück zum Zitat Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78:1471–8.PubMedCrossRef Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78:1471–8.PubMedCrossRef
8.
Zurück zum Zitat Williams LS, Rotich J, Qi R, Fineberg N, et al. Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology. 2002;59:67–71.PubMedCrossRef Williams LS, Rotich J, Qi R, Fineberg N, et al. Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology. 2002;59:67–71.PubMedCrossRef
9.
Zurück zum Zitat Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Critical Care Med. 2009;37:3001–9.CrossRef Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Critical Care Med. 2009;37:3001–9.CrossRef
10.
Zurück zum Zitat Tewari S, Kathuria A, Meier-Kriesche H-U, et al. Association between admission hyperglycemia and length of stay after renal transplantation. Endocr Pract. 2010;16:805–9.PubMedCrossRef Tewari S, Kathuria A, Meier-Kriesche H-U, et al. Association between admission hyperglycemia and length of stay after renal transplantation. Endocr Pract. 2010;16:805–9.PubMedCrossRef
11.
Zurück zum Zitat The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. New Engl J Med. 1993;329:977–86. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. New Engl J Med. 1993;329:977–86.
12.
Zurück zum Zitat van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. New Engl J Med. 2001;345:1359–67.PubMedCrossRef van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. New Engl J Med. 2001;345:1359–67.PubMedCrossRef
13.
Zurück zum Zitat Malmberg K, Rydén L, Efendic S, et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57–65.PubMedCrossRef Malmberg K, Rydén L, Efendic S, et al. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57–65.PubMedCrossRef
14.•
Zurück zum Zitat Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diab Care. 2011;34:256–61. Important paper on basal bolus insulin therapy.CrossRef Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diab Care. 2011;34:256–61. Important paper on basal bolus insulin therapy.CrossRef
15.
Zurück zum Zitat Shogbon AO, Levy SB. Intensive glucose control in the management of diabetes mellitus and inpatient hyperglycemia. Am J Health Syst Pharm. 2010;67:798–805.PubMedCrossRef Shogbon AO, Levy SB. Intensive glucose control in the management of diabetes mellitus and inpatient hyperglycemia. Am J Health Syst Pharm. 2010;67:798–805.PubMedCrossRef
16.
Zurück zum Zitat Jacobsen IB, Henriksen JE, Hother-Nielsen O, et al. Evidence-based insulin treatment in type 1 diabetes mellitus. Diabetes Res Clin Pract. 2009;86:1–10.PubMedCrossRef Jacobsen IB, Henriksen JE, Hother-Nielsen O, et al. Evidence-based insulin treatment in type 1 diabetes mellitus. Diabetes Res Clin Pract. 2009;86:1–10.PubMedCrossRef
17.
Zurück zum Zitat Standards of medical care in diabetes—2013. American Diabetes Association. Diab Care. 2013;36(Suppl 1):S11–66. Standards of medical care in diabetes—2013. American Diabetes Association. Diab Care. 2013;36(Suppl 1):S11–66.
18.
Zurück zum Zitat Vella S, Buetow L, Royle P, et al. The use of metformin in type 1 diabetes: a systematic review of efficacy. Diabetologia. 2010;53:809–20.PubMedCrossRef Vella S, Buetow L, Royle P, et al. The use of metformin in type 1 diabetes: a systematic review of efficacy. Diabetologia. 2010;53:809–20.PubMedCrossRef
19.
Zurück zum Zitat Wu P, Inskeep K, Bowker-Kinley MM, Popov KM, et al. Mechanism responsible for inactivation of skeletal muscle pyruvate dehydrogenase complex in starvation and diabetes. Diabetes. 1999;48:1593–9.PubMedCrossRef Wu P, Inskeep K, Bowker-Kinley MM, Popov KM, et al. Mechanism responsible for inactivation of skeletal muscle pyruvate dehydrogenase complex in starvation and diabetes. Diabetes. 1999;48:1593–9.PubMedCrossRef
20.
Zurück zum Zitat Pang TTL, Narendran P. Addressing insulin resistance in Type 1 diabetes. Diabetic Med. 2008;25:1015–24.PubMedCrossRef Pang TTL, Narendran P. Addressing insulin resistance in Type 1 diabetes. Diabetic Med. 2008;25:1015–24.PubMedCrossRef
21.
Zurück zum Zitat Beales PE, Pozzilli P. Thiazolidinediones for the prevention of diabetes in the non-obese diabetic (NOD) mouse: implications for human type 1 diabetes. Diabetes Metab Res Rev. 2002;18:114–7.PubMedCrossRef Beales PE, Pozzilli P. Thiazolidinediones for the prevention of diabetes in the non-obese diabetic (NOD) mouse: implications for human type 1 diabetes. Diabetes Metab Res Rev. 2002;18:114–7.PubMedCrossRef
22.
Zurück zum Zitat Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:16–38.PubMedCrossRef Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:16–38.PubMedCrossRef
23.
Zurück zum Zitat Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353–69.PubMedCrossRef Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353–69.PubMedCrossRef
24.
Zurück zum Zitat Clement S, Braithwaite SS, Magee MF, Ahmann A, et al. Management of diabetes and hyperglycemia in hospitals. Diab Care. 2004;27:553–91.CrossRef Clement S, Braithwaite SS, Magee MF, Ahmann A, et al. Management of diabetes and hyperglycemia in hospitals. Diab Care. 2004;27:553–91.CrossRef
25.
Zurück zum Zitat American College of Endocrinology and American Diabetes Association consensus statement on inpatient diabetes and glycemic control. Endocr Pract. 2006;12:458–68. American College of Endocrinology and American Diabetes Association consensus statement on inpatient diabetes and glycemic control. Endocr Pract. 2006;12:458–68.
26.
Zurück zum Zitat Dates R, Origin DO. Medical policy No. 91516-R5. Medical errors: serious reportable events. 2006;91516:1–13. Dates R, Origin DO. Medical policy No. 91516-R5. Medical errors: serious reportable events. 2006;91516:1–13.
27.
Zurück zum Zitat Vann MA. Perioperative management of ambulatory surgical patients with diabetes mellitus. Curr Opin Anesth. 2009;22:718–24.CrossRef Vann MA. Perioperative management of ambulatory surgical patients with diabetes mellitus. Curr Opin Anesth. 2009;22:718–24.CrossRef
28.
Zurück zum Zitat Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diab Care. 2009;32:1335–43. Important paper describing the presentation, pathogenesis, diagnosis, and management of DKA. CrossRef Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diab Care. 2009;32:1335–43. Important paper describing the presentation, pathogenesis, diagnosis, and management of DKA. CrossRef
29.
Zurück zum Zitat Beck RW, Tamborlane WV, Bergenstal RM, et al. The T1D Exchange clinic registry. J Clin Endocrinol Metab. 2012;97:4383–9.PubMedCrossRef Beck RW, Tamborlane WV, Bergenstal RM, et al. The T1D Exchange clinic registry. J Clin Endocrinol Metab. 2012;97:4383–9.PubMedCrossRef
30.•
Zurück zum Zitat Pickup JC. Insulin-pump therapy for type 1 diabetes mellitus. New Engl J Med. 2012;366:1616–24. Important paper on insulin pump therapy in T1DM.PubMedCrossRef Pickup JC. Insulin-pump therapy for type 1 diabetes mellitus. New Engl J Med. 2012;366:1616–24. Important paper on insulin pump therapy in T1DM.PubMedCrossRef
31.
Zurück zum Zitat Grunberger G, Bailey TS, Cohen AJ, et al. Statement by the American Association of Clinical Endocrinologists Consensus Panel on insulin pump management. Endocr Pract. 2010;16:746–62.PubMedCrossRef Grunberger G, Bailey TS, Cohen AJ, et al. Statement by the American Association of Clinical Endocrinologists Consensus Panel on insulin pump management. Endocr Pract. 2010;16:746–62.PubMedCrossRef
Metadaten
Titel
Management of Patients with Type 1 Diabetes in the Hospital
verfasst von
Divya Yogi-Morren
M. Cecilia Lansang
Publikationsdatum
01.02.2014
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 2/2014
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-013-0458-9

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