The future of inpatient diabetes management

Glucose as the sixth vital sign

Marc Rendell, Saraswathi Saiprasad, Alejandro G. Trepp-Carrasco, Andjela Drincic

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Diabetes is an ever increasing health problem in our society. Due to associated small and large vessel conditions, patients with diabetes are two- to four-fold more likely to require hospitalization than nondiabetic individuals. Furthermore, hyperglycemia in hospitalized patients results in increased susceptibility to wound infections, worse outcomes postcardiac and cerebrovascular events, longer hospital length of stay and increased inpatient mortality. Several studies suggest that tight control of glucose levels yields improvement in these factors. Conversely, other studies have suggested increased mortality after tight glucose management, perhaps as a result of an increased incidence of hypoglycemic events. The most reasonable approach to control of hyperglycemia is to normalize glucose levels as much as possible without triggering hypoglycemia. In the hospital, insulin therapy of hyperglycemia is preferred due to the ability to flexibly manage glucose levels without side effects associated with many alternative antidiabetic agents. Due to the increasing burden of inpatient diabetes, and the detrimental effects of both hyper and hypoglycemia, the authors predict that blood-glucose levels will become the sixth vital sign to be frequently monitored in hospitalized patients and controlled in a narrow range. The future is in the use of insulin pumps controlled by continuous glucose monitors. This technology is complex and has not yet become standard. The development of future inpatient diabetes care will depend on adaptation of hospital systems to advance the new technology.

Original languageEnglish
Pages (from-to)195-205
Number of pages11
JournalExpert Review of Endocrinology and Metabolism
Volume8
Issue number2
DOIs
StatePublished - 2013

Fingerprint

Vital Signs
Inpatients
Glucose
Hyperglycemia
Hypoglycemia
Hypoglycemic Agents
Length of Stay
Insulin
Technology
Mortality
Wound Infection
Blood Glucose
Hospitalization
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

The future of inpatient diabetes management : Glucose as the sixth vital sign. / Rendell, Marc; Saiprasad, Saraswathi; Trepp-Carrasco, Alejandro G.; Drincic, Andjela.

In: Expert Review of Endocrinology and Metabolism, Vol. 8, No. 2, 2013, p. 195-205.

Research output: Contribution to journalReview article

Rendell, Marc ; Saiprasad, Saraswathi ; Trepp-Carrasco, Alejandro G. ; Drincic, Andjela. / The future of inpatient diabetes management : Glucose as the sixth vital sign. In: Expert Review of Endocrinology and Metabolism. 2013 ; Vol. 8, No. 2. pp. 195-205.
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