Boris Draznin - Managing Diabetes and Hyperglycemia in the Hospital Setting: A Clinicians Guide

Director, Book Publishing, Abe Ogden; Managing Editor, Rebekah Renshaw; Acquisitions Editor, Victor Van Beuren; Production Manager, Melissa Sprott; Production Services, Cenveo Publisher Services; Cover Design, Lawrence Marie, Inc.; Printer, Data Reproduction Corp.

2016 by the American Diabetes Association, Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

Printed in the United States of America
1 3 5 7 9 10 8 6 4 2

The suggestions and information contained in this publication are generally consistent with the Standards of Medical Care in Diabetes and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in
this publication before prescribing any diet, exercise, or medication. The American Diabetes Associationits officers, directors, employees, volunteers, and membersassumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).

Jane Chiang, MD, conducted the internal review of this book to ensure that it meets American Diabetes Association guidelines.

ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at the address below or at booksales@diabetes.org.

American Diabetes Association
1701 North Beauregard Street
Alexandria, Virginia 22311

DOI: 10.2337/9781580406086

Library of Congress Cataloging-in-Publication Data
Names: Draznin, Boris, editor. | American Diabetes Association, issuing body.
Title: Managing diabetes and hyperglycemia in the hospital setting / Boris
Draznin, editor.
Description: Alexandria : The American Diabetes Association, [2016] |
Includes bibliographical references and index.
Identifiers: LCCN 2015045525 | ISBN 9781580406086 (alk. paper)
Subjects: | MESH: Hyperglycemiatherapy. | Diabetes Mellitustherapy. |
Hospitalization. | Hyperglycemiaprevention & control.
Classification: LCC RC660.7 | NLM WK 880 | DDC 616.4/62dc23 LC record available at http://lccn.loc.gov/2015045525

Contents

E. Moghissi and S. Inzucchi

I.B. Hirsch and L.M. Gaudiani

S.S. Braithwaite and I.B. Hirsch

R. Hellman

M. Korytkowski, B. Draznin, and A. Drincic

C.C. Low Wang, R.M. Hawkins, R. Gianchandani, and K. Dungan

N. Mathioudakis, K. Dungan, D. Baldwin, M. Korytkowski, and J. Reider

L.F. Lien, C.C. Low Wang, K. Evans Kreider, and D. Baldwin, Jr.

R. Gianchandani, E. Dubois, S. Alexanian, and R. Rushakoff

R.J. Rushakoff, H. Windham MacMaster, M. Falciglia, and K. Kulasa

A. Sadhu, A. Kansara, U. Masharani, D. Baldwin, R. Rushakoff, and A. Wallia

S.J. Healy, B. Draznin, and K.M. Dungan

B. Draznin and R. Gianchandani

J. Apel and D. Baldwin

B. Draznin, K. Dungan, and S. Seggelke

A. Diesburg-Stanwood, N. Rasouli, and B. Draznin

S. Kim, B. Draznin, and R.J. Rushakoff

S. Alexanian and I.Lingvay

M.F. Magee, C.M. Nassar, J.J. Reyes-Castano, and M.E. McDonnell

J. Calles-Escandn, K.L. Koch, B. Draznin, and A. Drincic

E.O. Buschur, M.E. McDonnell, M.K. Figaro, and E.M. Eggleston

J.S. Haw, R. Rushkoff, and G.E. Umpierrez

J.L. Gilden, D.J. Rubin, K. Kulasa, and G. Maynard

E. Faulds, R. Rushakoff, U. Masharani, and K. Dungan

P. Peter and S.E. Inzucchi

C.E. Mendez, R.Y. Gianchandani, and G.E. Umpierrez

K. Rodriguez, L. Meneghini, J. Jeffrie Seley, and M.F. Magee

J. Jeffrie Seley, M.F. Magee, and R.J. Rushakoff

R.J. Rushakoff, C. Low Wang, J. Jeffrie Seley, and A.L. Warnock

D.J. Rubin, L.F. Meneghini, J. Jeffrie Seley, E. Cagliero, L.M. Gaudiani, and J.L. Gilden

Sara Alexanian, MD
Jill Apel, MD
David Baldwin, Jr., MD
Susan S. Braithwaite, MD
Elizabeth O. Buschur, MD
Enrico Cagliero, MD
Jorge Calles-Escandn, MD
Amy Diesburg-Stanwood, DNP, FNP-BC
Boris Draznin, MD, PhD
Andjela Drincic, MD
Elizabeth Dubois, PA-C
Kathleen Dungan, MD, MPH
Emma M. Eggleston, MD
Kathryn Evans Kreider, DNP, APRN, FNP-BC
Mercedes Falciglia, MD, FACP
Eileen Faulds, CNP, CDE
M. Kathleen Figaro, MD
Linda M. Gaudiani, MD, FACP, FACE
Roma Gianchandani, MD
Janice L. Gilden, MS, MD, FCP, FACE
J. Sonya Haw, MD
R. Matthew Hawkins, PA-C, MMSc
Sara J. Healy, MD
Richard Hellman, MD, FACP, FACE
Irl B. Hirsch, MD, MACP
Silvio E. Inzucchi, MD
Jane Jeffrie Seley, DNP, MSN, MPH, GNP, BC-ADM, CDE, CDTC
Abhishek Kansara, MD
Sarah Kim, MD
Kenneth L. Koch, MD
Mary Korytkowski, MD
Kristen Kulasa, MD
Lillian F. Lien, MD
Ildiko Lingvay, MD, MPH, MSCS
Cecilia C. Low Wang, MD
Michelle Magee, MD, MBBCh, BAO, LRCPSI
Umesh Masharani, MD
Nestoras Mathioudakis, MD
Greg Maynard, MD, MSc, SFHM
Marie E. McDonnell, MD
Carlos E. Mendez, MD, FACP
Luigi F. Meneghini, MD, MBA
Etie Moghissi, MD, FACE
Carine M. Nassar, MS, RD, CDE
Patricia Peter, MD
Neda Rasouli, MD
Jodie Reider, MD
John J. Reyes-Castano, MD
Kellie Rodriguez, MSN, MBA, CDE
Daniel J. Rubin, MD, MSc, FACE
Robert J. Rushakoff, MD
Archana Sadhu, MD, FACE
Stacey Seggelke, RN, MS, CDE
Guillermo E. Umpierrez, MD
Amisha Wallia, MD
Alicia Lynn Warnock, MD, FACP
Heidemarie Windham MacMaster, PharmD, CDE, FCSHP

As the number of patients with diabetes, both diagnosed and as yet undiagnosed, increases annually, it is not surprising that the number of patients with diabetes who are admitted to the hospital also increases. The prevalence of overt diabetes is estimated to exceed 30% among individuals who are 60 years of age and older. Because individuals in this age-group account for a large number of hospital admissions for a variety of medical and surgical conditions, even conservative estimates suggest that ~25 to 30% of all hospitalized patients on any given day in any given hospital in the U.S. have diabetes. The percentage of hospitalized patients outside the U.S. who have diabetes is likely to show the same trend.

Even though patients with diabetes may be admitted to the hospital with acute or chronic complications of diabetes, most frequently they are hospitalized for other medical and surgical problems and their diabetes becomes a significant comorbidity that may affect the outcome of their hospitalization. Moreover, patients with prediabetes or undiagnosed diabetes are frequently hyperglycemic either on admission to the hospital or in the course of their hospital stay, adding to the complexity of their medical or surgical problems. The treatment of diabetes and hyperglycemia in these situations requires the utmost attention and specialized knowledge.