Tight glycaemic control: clinical implementation of protocols

  • F. N
  • P. L
  • N. D
 et al. 
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Abstract

Implementation of tight glycaemic control in hospitalised patients presents a huge challenge. It concerns many patients, there are many interfering factors and many health-care professionals are involved. The current literature provides little practical guidance. This article offers the clinical anesthesiologist direction for the organisation of inpatient blood glucose control in acute situations, in the perioperative setting and in the intensive care unit. An effective, safe and user-friendly algorithm for intravenous insulin administration is presented that can be executed by regular nurses and used in many situations. Practical advice is offered for the use of subcutaneous basal-bolus insulin, for fasting orders and for transition to discharge care. The main safety considerations are discussed. © 2009.

Author-supplied keywords

  • *clinical protocol
  • *glycemic control
  • algorithm
  • bedtime dosage
  • bolus injection
  • caloric intake
  • clinical effectiveness
  • corticosteroid/do [Drug Dose]
  • diabetes mellitus/dt [Drug Therapy]
  • diet restriction
  • diet supplementation
  • disease exacerbation
  • disease severity
  • drug contraindication
  • drug dose reduction
  • drug efficacy
  • drug megadose
  • drug targeting
  • early diagnosis
  • gliclazide/dt [Drug Therapy]
  • glucose blood level
  • glucose/ec [Endogenous Compound]
  • hospital discharge
  • hospital patient
  • hospitalization
  • human
  • hyperglycemia/dt [Drug Therapy]
  • hypoglycemia/di [Diagnosis]
  • hypoglycemia/pc [Prevention]
  • inotropic agent/do [Drug Dose]
  • insulin dependent diabetes mellitus/dt [Drug Thera
  • insulin derivative/dt [Drug Therapy]
  • insulin detemir
  • insulin glargine
  • insulin infusion
  • insulin sensitivity
  • insulin/do [Drug Dose]
  • insulin/dt [Drug Therapy]
  • insulin/iv [Intravenous Drug Administration]
  • insulin/sc [Subcutaneous Drug Administration]
  • intensive care
  • isophane insulin/do [Drug Dose]
  • isophane insulin/dt [Drug Therapy]
  • long acting drug/do [Drug Dose]
  • long acting drug/dt [Drug Therapy]
  • medication error
  • metabolic regulation
  • morning dosage
  • oral antidiabetic agent/dt [Drug Therapy]
  • oral antidiabetic agent/po [Oral Drug Administrati
  • patient care planning
  • patient safety
  • priority journal
  • prognosis
  • quality control
  • review
  • short acting drug/dt [Drug Therapy] XT - diabetes
  • surgical patient

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Authors

  • Nobels F.

  • Lecomte P.

  • Deprez N.

  • Van Pottelbergh I.

  • Van Crombrugge P.

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