Department of Medicine, University of Mississippi Medical Center, Jackson.
Department of Medicine, University of Mississippi Medical Center, Jackson; Division of Endocrinology, University of Mississippi Medical Center, Jackson; Department of Medicine, G.V. Montgomery VA Medical Center, Jackson, Miss.
Am J Med. 2016 Feb;129(2):139-42. doi: 10.1016/j.amjmed.2015.10.007. Epub 2015 Oct 29.
Uncontrolled hyperglycemia in hospitalized patients with or without a previous diagnosis of diabetes is associated with adverse outcomes and longer lengths of hospital stay. It is estimated that one-third of hospitalized patients will experience significant hyperglycemia, and the cost associated with hospitalization for patients with diabetes accounts for half of all health care expenditures for this disease. Optimizing glycemic control should be a priority for all health care providers in the inpatient setting. Appropriate management strategies should include identification of appropriate glycemic targets, prevention of hypoglycemia, initiation of appropriate basal-plus-bolus insulin regimens, and planning for the transition from inpatient to outpatient therapy before hospital discharge.
住院患者无论是否有糖尿病既往史，血糖控制不佳与不良结局和住院时间延长有关。据估计，有三分之一的住院患者会出现明显的高血糖，而糖尿病患者的住院费用占该疾病所有医疗费用的一半。优化血糖控制应该是住院环境中所有医疗保健提供者的首要任务。适当的管理策略应包括确定适当的血糖目标、预防低血糖、启动适当的基础-餐时胰岛素方案，以及在出院前规划从住院治疗向门诊治疗的过渡。
