Category: Federal Forum Posters
Purpose: Diabetes affects over thirty million US adults and is a leading cause of kidney failure, lower-limb amputations, blindness, and death. Diabetes in the US is estimated to cost over $327 billion annually. Clinical guidelines recognize that hyperglycemia is associated with adverse outcomes and recommend a management approach in non-critically ill patients that involves basal, nutritional, and bolus correction insulin. Although dosing recommendations are not provided, guidelines also recognize that factors like weight or glucocorticoid therapy can contribute to increased insulin resistance. The objective of this study is to review hyperglycemia management in hospitalized patients, focusing on the insulin regimen used.
Methods: Using retrospective chart review, 100 patients with a diagnosis of type 2 diabetes will be identified that are on correction insulin and who are also overweight, obese, or on glucocorticoid therapy. Glucocorticoids that will be evaluated are prednisone and methylprednisolone. Overweight will be defined as BMI 25-29.9 kg/m2 and obesity will be defined as BMI >30 kg/m2. The following data will be collected: patient age, gender, length of stay, BMI, creatinine clearance, glycated hemoglobin (A1C), current medications, point-of-care (POC) blood glucose (BG) values (fasting and non-fasting), sliding scale insulin regimen, and hospital diet order. Mean POC blood glucose values for fasting and non-fasting will be calculated. All data will be recorded without patient identifiers and maintained confidentially. The data collected will be reviewed to evaluate how hyperglycemia was managed in non-critically ill hospitalized patients. The effects of steroid use and weight on BG levels, the level of BG control, insulin regimen used, patient monitoring, and patient outcomes will also be reviewed.
Results: not applicable
Conclusion: not applicable
Lin Tran– Pharmacy Resident, Philadelphia VA Medical Center, Philadelphia, PA