Blog | Monday, January 9, 2012

QD: News Every Day--Endocrine Society recommends glucose tests for all hospital patients

The Endocrine Society released new recommendations that suggest all hospitalized patients receive blood glucose testing, regardless of their current diabetes status.

The guidelines, which appeared in the January issue of the Journal of Clinical Endocrinology & Metabolism outline recommendations on glucose monitoring for hospitalized and primary care patients, as well as transitions between home and hospital, surgical considerations and other special scenarios.

Observational studies report that hyperglycemia is present in about one-third of patients in community hospitals, The Endocrine Society stated in a press release.

"Hyperglycemia is associated with prolonged hospital stay, increased incidence of infections and death in non-critically ill hospitalized patients," said Guillermo Umpierrez, MD, FACP, chair of the task force that authored the recommendations. "This new guideline contains consensus recommendations from experts in the field for the management of hyperglycemia in hospitalized patients in non-critical care settings."

Specific recommendations include:
--Glycemic targets should include a pre-meal glucose target of less than 140 mg/dl and a random blood glucose of less than 180 mg/dl for the majority of hospitalized patients with non-critical illness;
--All patients with diabetes treated with insulin at home should be treated with a scheduled subcutaneous insulin regimen in the hospital;
--All patients with type 1 diabetes and most patients with type 2 diabetes who undergo surgical procedures should receive either intravenous continuous insulin infusion or subcutaneous basal insulin with bolus insulin as required to prevent hyperglycemia during the perioperative period;
--Bedside point-of-care glucose testing should be initiated in all patients with high glucose values on admission and in patients with or without a history of diabetes receiving nutrition either through IV or a feeding tube; and
--All patients with type 1 and type 2 diabetes should be transitioned to scheduled subcutaneous insulin therapy at least one to two hours before stopping IV continuous insulin infusion.

A companion patient guide is online.