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In-Hospital Management of Diabetes Mellitus

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Dr Arpan Dev Bhattacharyya, Bengaluru    20 November 2018

  1. Diabetes control in hospital is important.
  2. The target needs to be clear.
  3. Insulin is certainly the agent of choice.
  4. TEAM approach is the KEY to success.
  5. Regular audit of our own work helps to improve the quality of care we provide.
  6. Glycemic targets that can be recommended in different patient populations – Not recommended: <110 and >180 mg/dL; May be appropriate: 110-140 mg/dL; recommended: 140-180 mg/dL.
  7. Criteria of good control – Good: 80% or more; suboptimal: 40-80%; poor: <40% (in the target range).
  8. A survey at the Manipal Hospital suggested that increased attention needs to be paid to improving glycemic control in patients hospitalized for reasons other than diabetes. Using subcutaneous insulin, glycemic control was good in 48%, suboptimal in 15%, and poor in 37% of patients. The corresponding numbers while on intravenous insulin were 45%, 11% and 46%, respectively (Deepak PJ, et al. Postgrad Med J. 2003;79(936):585-7).

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