Details

Autor(en) / Beteiligte

• Moghissi, Etie S
• Korytkowski, Mary T
• DiNardo, Monica
• Einhorn, Daniel
• Hellman, Richard
• Hirsch, Irl B
• Inzucchi, Silvio E
• Ismail-Beigi, Faramarz
• Kirkman, M. Sue
• Umpierrez, Guillermo E

Titel

American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control

Ist Teil von

• Diabetes care, 2009-06, Vol.32 (6), p.1119-1131

Ort / Verlag

United States: American Diabetes Association

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• [...] recent trials in critically ill patients have failed to show a significant improvement in mortality with intensive glycemic control (12,13) or have even shown increased mortality risk (14). [...] these recent RCTs have highlighted the risk of severe hypoglycemia resulting from such efforts (12-17). A sixfold increase in severe hypoglycemic events (BG <40 mg/dl [2.2 mmol/1]) was observed in the intensively treated group (18.7 vs. 3.1%), and hypoglycemia was identified as an independent risk factor for mortality (16).\n * Less stringent targets may be appropriate in terminally ill patients or in patients with severe comorbidities. * Scheduled subcutaneous administration of insulin, with basal, nutritional, and correction components, is the preferred method for achieving and maintaining glucose control. * Prolonged therapy with SSI as the sole regimen is discouraged. * Noninsulin antihyperglycemic agents are not appropriate in most hospitalized patients who require therapy for hyperglycemia. * Clinical judgment and ongoing assessment of clinical status must be incorporated into day-to-day decisions regarding treatment of hyperglycemia.