Emory University School of Medicine, Atlanta, Georgia 30322, USA.
J Clin Endocrinol Metab. 2012 Jan;97(1):16-38. doi: 10.1210/jc.2011-2098.
The aim was to formulate practice guidelines on the management of hyperglycemia in hospitalized patients in the non-critical care setting.
The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee of The Endocrine Society, six additional experts, and a methodologist.
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence.
One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society members, American Diabetes Association, American Heart Association, American Association of Diabetes Educators, European Society of Endocrinology, and the Society of Hospital Medicine reviewed and commented on preliminary drafts of this guideline.
Hyperglycemia is a common, serious, and costly health care problem in hospitalized patients. Observational and randomized controlled studies indicate that improvement in glycemic control results in lower rates of hospital complications in general medicine and surgery patients. Implementing a standardized sc insulin order set promoting the use of scheduled basal and nutritional insulin therapy is a key intervention in the inpatient management of diabetes. We provide recommendations for practical, achievable, and safe glycemic targets and describe protocols, procedures, and system improvements required to facilitate the achievement of glycemic goals in patients with hyperglycemia and diabetes admitted in non-critical care settings.
制定非重症监护环境下住院患者高血糖管理的实践指南。
专家组由内分泌学会临床指南小组委员会选定的主席、六名额外的专家以及一名方法学家组成。
本循证指南使用推荐分级的评估、制定与评价（GRADE）系统制定，以描述建议的强度和证据的质量。
一次小组会议、多次电话会议和电子邮件沟通促成了共识。内分泌学会成员、美国糖尿病协会、美国心脏协会、美国糖尿病教育者协会、欧洲内分泌学会和医院医学学会审查并评论了本指南的初步草案。
高血糖是住院患者中常见、严重且代价高昂的医疗保健问题。观察性和随机对照研究表明，改善血糖控制可降低普通内科和外科患者的住院并发症发生率。实施标准化 sc 胰岛素医嘱集，促进使用预定基础和营养胰岛素治疗，是糖尿病住院管理的关键干预措施。我们为非重症监护环境下住院的高血糖和糖尿病患者提供了实用、可实现且安全的血糖目标建议，并描述了实现血糖目标所需的协议、程序和系统改进。
