The Perils of Inpatient Hyperglycemia Management: How We Turned Apathy Into Action
- Carrie C. Lubitz, MD,
- Jane Jeffrie Seley, GNP, MPH, MSN, CDE,
- Cristina Rivera, MD,
- Naina Sinha, MD and
- David J. Brillon, MD
- Address correspondence to Jane Jeffrie Seley, GNP, MPH, MSN, CDE, New York Presbyterian/WC, Box 136 Endocrine, 525 East 68 St., New York, NY 10021
Abstract
As the number of Americans with prediabetes and diabetes continues to grow, so too will the number of patients who come into the hospital with hyperglycemia. Although tight glycemic control has been a well-established goal in the outpatient setting, it has only recently gained heightened interest in the inpatient arena. There is a growing body of knowledge supporting the benefits of strict glycemic control in hospitalized patients, yet there is little or no formal didactic training for health care professionals in inpatient management of patients with diabetes. Despite widespread inpatient hypoglycemic and hyperglycemic events, there are few systems in place for effective diabetes care and management.
In January 2006, the American Association of Clinical Endocrinologists, the American College of Endocrinology, and the American Diabetes Association convened a meeting titled “Improving Inpatient Diabetes Care: A Call to Action Consensus Development Conference,” which concluded that facilitating these changes required a paradigm shift that involves modifying both individual and institutional beliefs and practices that have been status quo for decades. One of the key consensus recommendations was the formation of an interdisciplinary steering committee to identify deficits, develop strategies, and facilitate the implementation of interventions to improve inpatient care. This article illustrates the planning and implementation of a systems-wide model to conquer inpatient hyperglycemia in an academic medical center.
Footnotes
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Carrie C. Lubitz, MD, is a senior general surgery resident in the Department of Surgery at Weill Medical College of Cornell University in New York, N.Y. Jane Jeffrie Seley, GNP, MPH, MSN, CDE, is the Diabetes Nurse Practitioner in the Department of Nursing at New York Presbyterian/Weill Cornell Hospital. Cristina Rivera, MD, is a senior assistant resident in the Department of Medicine; Naina Sinha, MD, is an assistant professor of medicine; and David J. Brillon, MD, is an associate professor of clinical medicine in the Department of Medicine, Division of Endocrinology, at Weill Medical College of Cornell University.
- American Diabetes Association
