Diabetes Care in the Hospital Setting

Jump to navigation Jump to search

2016 ADA Guideline Recommendations

Types of Diabetes Mellitus

Main Diabetes Page

Diabetes type I

Diabetes type II

Gestational Diabetes Mellitus

2016 ADA Standard of Medical Care Guideline Recommendations

Strategies for Improving Care

Classification and Diagnosis of Diabetes

Foundations of Care and Comprehensive Medical Evaluation

Diabetes Self-Management, Education, and Support
Nutritional Therapy

Prevention or Delay of Type II Diabetes

Glycemic Targets

Obesity Management for Treatment of Type II Diabetes

Approaches to Glycemic Treatment

Cardiovascular Disease and Risk Management

Hypertension and Blood Pressure Control
Lipid Management
Antiplatelet Agents
Coronary Heart Disease

Microvascular Complications and Foot Care

Diabetic Kidney Disease
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Footcare

Older Adults with Diabetes

Children and Adolescents with Diabetes

Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes
Microvascular Complications in Children and Adolescents with Diabetes

Management of Diabetes in Pregnancy

Diabetes Care in the Hospital Setting

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]; Shivani Chaparala M.B.B.S [3]; Tarek Nafee, M.D. [4]


Patient status Mild hyperglycaemia Moderate hyperglycaemia Severe hyperglycaemia
Definition Blood glucose < 200
Patients who are taking less than 2 anti-diabetic drugs (such as oral anti-diabetic drug or GLP-1 receptor agonists)
201 < Blood glucose <300
Patients who are taking multiple anti-diabetic drug (such as oral anti-diabetic drug or GLP-1 receptor agonists)
Patients who are taking less than 0·6 U/kg insulin per day
Blood glucose > 301
Patients who are taking multiple anti-diabetic drug (such as oral anti-diabetic drug or GLP-1 receptor agonists)
Patients who are taking more than 0·6 U/kg insulin per day
Approach Low dose basal insulin OR oral anti-diabetic drug†, if there are no contraindications.
Further blood glucose correction can be applied by rapid-acting insulin (before meals or every 6 hours)
Basal insulin OR oral anti-diabetic drug†, if there are no contraindications.
Initial insulin dose: 0·2–0·3 U/kg per day (start from 0·15 U/kg per day (if using basal insulin alone) or 0·3 U/kg per day (if using basal–bolus) for patients with high risk of hypoglycemia).
Further blood glucose correction can be applied by rapid-acting insulin (before meals or every 6 hours)
Basal–bolus insulin regimen
Initial insulin dose: Reduce patient's home insulin regimen by 20% OR 0·3 U/kg per day (half basal and half bolus)
If patient has poor intake, hold the prandial insulin.

†One of the options which has been studied in randomized controlled trials is dipeptidyl peptidase-4 inhibitor. Although metformin use is common, use it with caution due to high risk of lactic acidosis, especially in high risk patients (such as sepsis, hypoxia, renal insufficiency, shock and hepatic failure)



Patient status Patients with surgical or other medical conditions‡ Mild to moderate DKA Severe DKA or HHS
Approach Continuous insulin infusion § Continuous insulin infusion OR subcutaneous insulin (consider DKA protocol) Continuous insulin infusion

‡Continuous insulin infusion specially could be beneficial in hypoglycemia due to steroid use or in solid organ transplant patients.
§Prompt treatment is recommended in patients with myocardial infarction or ischemic stroke due to possible further harm due to hyperglycemia. ALthough intensive treatment is not recommended due to higher chance of hypoglycemia.

2016 ADA Standards of Medical Care in Diabetes Guidelines

"1. Consider performing an A1C on all patients with diabetes or hyperglycemia admitted to the hospital if not performed in the previous 3 months. (Level of Evidence: C)"
"2. Insulin therapy should be initiated for treatment of persistent hyperglycemia starting at a threshold ≥180 mg/dL (10.0 mmol/L). Once insulin therapy is started, a target glucose range of 140–180 mg/dL (7.8–10.0 mmol/L) is recommended for the majority of critically ill patients(Level of Evidence: A)and noncritically ill patients (Level of Evidence: C)"
"3. More stringent goals, such as 110–140 mg/dL (6.1–7.8 mmol/L) may be ap- propriate for selected critically ill patients, as long as this can be achieved without significant hypoglycemia (Level of Evidence: C)"
"4. Intravenous insulin infusions should be administered using validated written or computerized protocols that allow for predefined adjustments in the insulin infusion rate based on glycemic fluctuations and insulin dose. (Level of Evidence: E)"
"5. A basal plus bolus correction insulin regimen is the preferred treatment for noncritically ill patients with poor oral intake or those who are taking nothing by mouth. An insulin regimen with basal, nutritional, and correction components is the preferred treatment for patients with good nutritional intake. (Level of Evidence: A)"
"6. The sole use of sliding scale insulin in the inpatient hospital setting is strongly discouraged (Level of Evidence: A)"
"7. A hypoglycemia management protocol should be adopted and implemented by each hospital or hospital system. A plan for preventing and treating hypoglycemia should be established for each patient. Episodes of hypoglycemia in the hospital should be documented in the medical record and tracked. (Level of Evidence: E)"
"8. The treatment regimen should be reviewed and changed if necessary to prevent further hypoglycemia when a blood glucose value is <70 mg/dL (3.9 mmol/L). (Level of Evidence: C)"
"9. There should be a structured discharge plan tailored to the individual patient. (Level of Evidence: B)"


Insulin Treatment


Umpierrez et al (2007) Glargineglulisine (basal-bolus) Vs sliding-scale insulin
Study has been done on 130 patients with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·4 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration in basal-bolus group has been 166 mg/dL (SD: 1.8) Vs average glucose concentration of 193 mg/dL in sliding-scale insulin group (P value < 0·001).
Non of the patients developed hypoglycemia (glucose concentrations less than 40 mg/dl).
Umpierrez et al (2009) Human insulin (NPH and regular) † Vs detemiraspart (basal-bolus)
Study has been done on 130 patients with diabetes type 2 who were on various type of treatments, with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed no difference.
4·5% of patients in detemiraspart group developed hypoglycemia (glucose concentrations less than 40 mg/dl Vs 1·6% of patients in human insulin.
Umpierrez et al (2011) Glargineglulisine (basal-bolus) Vs sliding-scale insulin
Study has been done on 211 surgical patients with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·4 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed better glycemic control in basal-bolus group (P value = 0·003 ).
Patients in basal-bolus group showed lower rate of general complications₪, nevertheless rates of hypoglycemia were higher (4% in basal-bolus group Vs 0% in sliding-scale insulin group).
Schroeder et al (2012) NPH and regular‡ Vs sliding-scale insulin
Study has been done on 141 orthopaedic surgery patients with diabetes type 2 or history of frequent hyperglycemia (>180 mg/dL).
Reported average glucose concentration in NPH and regular group has been 161·2 mg/dL Vs average glucose concentration of 175·8 mg/dL in sliding-scale insulin group (P value < 0·0005).
Two episodes of severe hypoglycemia have been reported in NPH and regular group.
Umpierrez et al (2013) Basal-plus (glargineglulisine) Vs basal-bolus (glargineglulisine) Vs sliding-scale insulin
Study has been done on 375 patients with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·4 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentrations were akin in both basal-plus and basal-bolus groups. Treatment failure was higher in sliding-scale insulin group (19%), compared to basal-bolus (0%) or basal-plus (2%) groups.
Mader et al (2014) Glargineaspart (basal-bolus) Vs standard treatment (such as oral antidiabetic agents), insulin or combination of both
Study has been done on 74 patients with diabetes type 2 who were on various type of treatments, with glucose concentrations higher than 140 mg/dL.
Reported average glucose concentration in basal-bolus group (33%) was higher compared to standard treatment group (23%) (P value 0·001) ¶
Bueno et al (2015) Glargineglulisine (basal-bolus) Vs NPH and regular
Study has been done on 134 patients with diabetes type 2 who were not a surgical case.
Reported average glucose concentrations were akin in both NPH and regular and basal-bolus groups.
Hypoglycemic events were reported as 35% in basal-bolus group, compared to 38% in NPH and regular group.
Bellido et al (2015) Glargineglulisine (basal-bolus) Vs premixed NPH and regular (70/30)¥
Study has been done on 72 patients with diabetes type 2 who were either medical or surgical cases, who were on oral antidiabetic agents, insulin or a combination of both.§
Reported average glucose concentration showed no difference.
Objectionably high rate of hypoglycemia have been reported in premixed NPH and regular group.
Vellanki et al (2015) Glargineaspart (basal-bolus) without bedtime addition Vs Glargineaspart (basal-bolus) with bedtime addition
Study has been done on 206 patients with diabetes type 2 who were medical or surgical cases with glucose concentrations of 140–400 mg/dL. Patients were on oral antidiabetic agents, insulin or a combination of both.
Reported average glucose concentration showed no difference.
Non of the patients developed hypoglycemia (glucose concentrations less than 40 mg/dl).
Gracia-Ramos et al (2016) Glarginelispro (basal-plus) Vs premixed insulin analog (lispro 25/75) ¤
Study has been done on 54 patients with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·4 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentrations showed no difference.
Rate of hypoglycemia was simillar in both groups (16%).
Pasquel et al (2020) Basal-bolus (glargine U300glulisine) Vs basal-bolus (glargine U100glulisine)
Study has been done on 176 patients with diabetes type 2 who were on various type of treatments, with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed no difference.
Significant lower rate of hypoglycemic events in glargine U300 group. (P value = 0·023)

†Two-thirds before breakfast and one-third before dinner
Patients in basal-bolus group showed lower rate of general complications such as postoperative wound infection, bacteremia, pneumonia, renal insufficiency and respiratory failure.
‡Three times a day
¶Related article didn't provide the absolute numbers
NPH insulin has been used twise a day. Regular insulin has been used before meals
¥60% before breakfast and 40% before dinner
§Study terminated after interim analysis.
¤Two-thirds with breakfast and one-third with dinner

Non-Insulin Treatments

Dipeptidyl Peptidase-4 Inhibitor Medications

Glucagon-Like Peptide-1 Analogs


Umpierrez et al (2013) Sitagliptin + sliding-scale insulin or sitagliptin + glargine Vs basal-bolus insulin (glarginelispro)
Study has been done on 90 patients (medical or surgical cases) with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·4 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed no difference.
Sole sitagliptin treatment has not been effective in patients who had blood glucose higher than 180 mg/dL.
Pasquel et al (2017) Sitagliptin + glargine Vs basal-bolus insulin (glarginelispro or glargineaspart)
Study has been done on 278 patients (medical or surgical cases) with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·6 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed no difference.
Garg et al (2017) Saxagliptin Vs basal-bolus insulin (glargineaspart)
Study has been done on 66 patients (medical or surgical cases) with diabetes type 2 who were on maximum 1 non-insulin antidiabetic agents or 2 non-insulin antidiabetic agents with HbA1c measure less than 7·5% and 7·0%, respectively.
Reported average glucose concentration showed no difference.
Patients who received saxagliptin showed less blood glucose variation.
Vellanki et al (2019) Linagliptin + sliding-scale insulin Vs basal-bolus insulin (glarginelispro or glargineaspart)
Study has been done on 250 surgical patients with diabetes type 2 who were on oral antidiabetic agents or low dose insulin (less than 0·5 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed no difference.
Less chance of hypoglycemia has been reported in linagliptin group. Sole linagliptin use has not been effective in patients with blood glucose more than 200 mg/dl
Abuannadi et al (2013) Exenatide infusion Vs intensive glycemic control (90–119 mg/dL) or moderate glycemic control (100–140 mg/dL)
Study has been done on 40 non-diabetic ICU patients with coronary heart disease and type 2 diabetic patients who were on non-insulin antidiabetic agents, with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed good control in exenatide group. (Same result as moderate glycemic control)
The main limitation has been the non-randomized study with historical controls.
Kohl et al (2014) Native GLP-1 Vs placebo
Study has been done on 77 cardiac surgery patients with or without diabetes
Reported average glucose concentration showed lower measure in GLP-1 group.
Besch et al (2017) Exenatide infusion Vs insulin infusion
Study has been done on 104 CABG patients with or without diabetes (on non-insulin treatment)
Reported average glucose concentration showed no statistically valuable differences.
Study discontinued after futility analysis.
Polderman et al (2018) Liraglutide † Vs glucose + insulin + potassium
Study has been done on 150 surgical patients with diabetes type 2 who where on diet, oral antidiabetic agents or insulin doses less than 1 U/kg.
Reported average glucose concentration measures 1 hour after surgery showed lower levels in liraglutide group.
Nausea has been reported in patients of liraglutide.
Lipš et al (2017) Continuous exenatide infusion + insulin treatment Vs 0·9% saline + insulin treatment
Study has been done on 40 CABG patients with or without diabetes.
Reported average glucose concentration showed lower measures in exenatide group.
Decreased demand for temporary pacing after surgery was the only benefit in cardiac function of the exenatide group.
Fayfman et al (2019) Exenatide ¶ Vs exenatide + basal insulin (glargine or levemir) Vs basal insulin (glargine or levemir + aspart or lispro)
Study has been done on 150 surgical or medical patients with diabetes type 2 who were on diet, oral antidiabetic agents or low dose insulin (less than 0·5 U/kg per day), with glucose concentrations of 140–400 mg/dL.
Reported average glucose concentration showed lower measures in exenatide plus basal insulin group, compared to exenatide alone. ALthough reported average glucose concentration showed no differences between exenatide plus basal insulin and basal insulin groups. Exenatide plus basal insulin group was more succesful in keeping the blood glucose within the target goal, compared to the other two groups. (P value = 0·023)
Kaneko et al (2018) Liraglutide Vs insulin
Study has been done on 92 surgical patients (elective surgery) with diabetes type 2
Reported average glucose concentration showed lower measures in liraglutide group.
Hulst et al (2020) Liraglutide ₳ Vs placebo
Study has been done on 278 cardiac surgery patients with (16%) or without (84%) diabetes type 2
Reported average glucose concentration showed lower demand for insulin use in liraglutide group.
Hypoglycemia has not been reported in non of the groups.

Liraglutide has been used subcutaneously with dosage of 0·6 mg before surgery and 1.2 mg after anesthesia induction.
‡Infusion of glucose, insulin and potassium was 30 mintunes before surgery and continued until 4 hours after surgery.
Exenatide has been used with dose of 5 mg twice a day.
Liraglutide has been used subcutaneously with dosage of 0·6 mg on the evening before surgery and 1.2 mg after anesthesia induction.

SGLT2 Inhibitors

Metformin

Sulfonylureas

Thiazolidinediones

Specific Circumstances

The following are some management considerations that are recommended in hospitalized diabetic patients with specific circumstances.

Medical Nutrition Therapy

Concurrent Glucocorticoid Use

Preoperative State

Hospital Technologies

Continuous Glucose Monitoring

Continuous Subcutaneous Insulin Pumps

Closed Loop Insulin Delivery System

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 Pasquel FJ, Lansang MC, Dhatariya K, Umpierrez GE (2021). "Management of diabetes and hyperglycaemia in the hospital". Lancet Diabetes Endocrinol. 9 (3): 174–188. doi:10.1016/S2213-8587(20)30381-8. PMID 33515493 Check |pmid= value (help).
  2. 2.0 2.1 Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009). "Hyperglycemic crises in adult patients with diabetes". Diabetes Care. 32 (7): 1335–43. doi:10.2337/dc09-9032. PMC 2699725. PMID 19564476.
  3. Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W; et al. (2019). "Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial". JAMA. 322 (4): 326–335. doi:10.1001/jama.2019.9346. PMC 6652154 Check |pmc= value (help). PMID 31334795. Review in: Ann Intern Med. 2019 Dec 17;171(12):JC67
  4. Christensen MB, Gotfredsen A, Nørgaard K (2017). "Efficacy of basal-bolus insulin regimens in the inpatient management of non-critically ill patients with type 2 diabetes: A systematic review and meta-analysis". Diabetes Metab Res Rev. 33 (5). doi:10.1002/dmrr.2885. PMID 28067472.
  5. Gómez Cuervo C, Sánchez Morla A, Pérez-Jacoiste Asín MA, Bisbal Pardo O, Pérez Ordoño L, Vila Santos J (2016). "Effective adverse event reduction with bolus-basal versus sliding scale insulin therapy in patients with diabetes during conventional hospitalization: Systematic review and meta-analysis". Endocrinol Nutr. 63 (4): 145–56. doi:10.1016/j.endonu.2015.11.008. PMID 26826772.
  6. American Diabetes Association (2018). "14. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2018". Diabetes Care. 41 (Suppl 1): S144–S151. doi:10.2337/dc18-S014. PMID 29222385.
  7. 7.0 7.1 Umpierrez GE, Hellman R, Korytkowski MT, Kosiborod M, Maynard GA, Montori VM; et al. (2012). "Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline". J Clin Endocrinol Metab. 97 (1): 16–38. doi:10.1210/jc.2011-2098. PMID 22223765.
  8. 8.0 8.1 8.2 Umpierrez GE, Smiley D, Hermayer K, Khan A, Olson DE, Newton C; et al. (2013). "Randomized study comparing a Basal-bolus with a basal plus correction insulin regimen for the hospital management of medical and surgical patients with type 2 diabetes: basal plus trial". Diabetes Care. 36 (8): 2169–74. doi:10.2337/dc12-1988. PMC 3714500. PMID 23435159.
  9. Zaman Huri H, Permalu V, Vethakkan SR (2014). "Sliding-scale versus basal-bolus insulin in the management of severe or acute hyperglycemia in type 2 diabetes patients: a retrospective study". PLoS One. 9 (9): e106505. doi:10.1371/journal.pone.0106505. PMC 4152280. PMID 25181406.
  10. 10.0 10.1 Bueno E, Benitez A, Rufinelli JV, Figueredo R, Alsina S, Ojeda A; et al. (2015). "BASAL-BOLUS REGIMEN WITH INSULIN ANALOGUES VERSUS HUMAN INSULIN IN MEDICAL PATIENTS WITH TYPE 2 DIABETES: A RANDOMIZED CONTROLLED TRIAL IN LATIN AMERICA". Endocr Pract. 21 (7): 807–13. doi:10.4158/EP15675.OR. PMID 26121460.
  11. Newsom R, Patty C, Camarena E, Sawyer R, McFarland R, Gray T; et al. (2018). "Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System". J Diabetes Sci Technol. 12 (1): 53–59. doi:10.1177/1932296817747619. PMC 5761993. PMID 29237289.
  12. NICE-SUGAR Study Investigators. Finfer S, Chittock DR, Su SY, Blair D, Foster D; et al. (2009). "Intensive versus conventional glucose control in critically ill patients". N Engl J Med. 360 (13): 1283–97. doi:10.1056/NEJMoa0810625. PMID 19318384. Review in: J Fam Pract. 2009 Aug;58(8):424-6 Review in: Ann Intern Med. 2009 Aug 18;151(4):JC2-5
  13. Kreider KE, Lien LF (2015). "Transitioning safely from intravenous to subcutaneous insulin". Curr Diab Rep. 15 (5): 23. doi:10.1007/s11892-015-0595-4. PMID 25772640.
  14. Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB; et al. (2009). "American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control". Diabetes Care. 32 (6): 1119–31. doi:10.2337/dc09-9029. PMC 2681039. PMID 19429873.
  15. 15.0 15.1 15.2 Umpierrez GE, Smiley D, Jacobs S, Peng L, Temponi A, Mulligan P; et al. (2011). "Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery)". Diabetes Care. 34 (2): 256–61. doi:10.2337/dc10-1407. PMC 3024330. PMID 21228246.
  16. Mader JK, Neubauer KM, Schaupp L, Augustin T, Beck P, Spat S; et al. (2014). "Efficacy, usability and sequence of operations of a workflow-integrated algorithm for basal-bolus insulin therapy in hospitalized type 2 diabetes patients". Diabetes Obes Metab. 16 (2): 137–46. doi:10.1111/dom.12186. PMID 23910952.
  17. Vellanki P, Bean R, Oyedokun FA, Pasquel FJ, Smiley D, Farrokhi F; et al. (2015). "Randomized controlled trial of insulin supplementation for correction of bedtime hyperglycemia in hospitalized patients with type 2 diabetes". Diabetes Care. 38 (4): 568–74. doi:10.2337/dc14-1796. PMC 4370326. PMID 25665812.
  18. Pasquel FJ, Lansang MC, Khowaja A, Urrutia MA, Cardona S, Albury B; et al. (2020). "A Randomized Controlled Trial Comparing Glargine U300 and Glargine U100 for the Inpatient Management of Medicine and Surgery Patients With Type 2 Diabetes: Glargine U300 Hospital Trial". Diabetes Care. 43 (6): 1242–1248. doi:10.2337/dc19-1940. PMC 7411278 Check |pmc= value (help). PMID 32273271 Check |pmid= value (help).
  19. Umpierrez GE, Pasquel FJ (2017). "Management of Inpatient Hyperglycemia and Diabetes in Older Adults". Diabetes Care. 40 (4): 509–517. doi:10.2337/dc16-0989. PMC 5864102. PMID 28325798.
  20. 20.0 20.1 20.2 Roberts AW, Penfold S, Joint British Diabetes Societies (JBDS) for Inpatient Care (2018). "Glycaemic management during the inpatient enteral feeding of people with stroke and diabetes". Diabet Med. 35 (8): 1027–1036. doi:10.1111/dme.13678. PMID 30152589.
  21. Amir M, Sinha V, Kistangari G, Lansang MC (2020). "CLINICAL CHARACTERISTICS OF PATIENTS WITH TYPE 2 DIABETES MELLITUS CONTINUED ON ORAL ANTIDIABETES MEDICATIONS IN THE HOSPITAL". Endocr Pract. 26 (2): 167–173. doi:10.4158/EP-2018-0524. PMID 31557075.
  22. 22.0 22.1 Garg R, Schuman B, Hurwitz S, Metzger C, Bhandari S (2017). "Safety and efficacy of saxagliptin for glycemic control in non-critically ill hospitalized patients". BMJ Open Diabetes Res Care. 5 (1): e000394. doi:10.1136/bmjdrc-2017-000394. PMC 5372055. PMID 28405346.
  23. 23.0 23.1 Fayfman M, Galindo RJ, Rubin DJ, Mize DL, Anzola I, Urrutia MA; et al. (2019). "A Randomized Controlled Trial on the Safety and Efficacy of Exenatide Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes". Diabetes Care. 42 (3): 450–456. doi:10.2337/dc18-1760. PMC 6905476 Check |pmc= value (help). PMID 30679302.
  24. Nauck MA, Meier JJ (2020). "Reduced COVID-19 Mortality With Sitagliptin Treatment? Weighing the Dissemination of Potentially Lifesaving Findings Against the Assurance of High Scientific Standards". Diabetes Care. 43 (12): 2906–2909. doi:10.2337/dci20-0062. PMID 33033068 Check |pmid= value (help).
  25. Sokos GG, Bolukoglu H, German J, Hentosz T, Magovern GJ, Maher TD; et al. (2007). "Effect of glucagon-like peptide-1 (GLP-1) on glycemic control and left ventricular function in patients undergoing coronary artery bypass grafting". Am J Cardiol. 100 (5): 824–9. doi:10.1016/j.amjcard.2007.05.022. PMID 17719327.
  26. 26.0 26.1 26.2 Polderman JAW, van Steen SCJ, Thiel B, Godfried MB, Houweling PL, Hollmann MW; et al. (2018). "Peri-operative management of patients with type-2 diabetes mellitus undergoing non-cardiac surgery using liraglutide, glucose-insulin-potassium infusion or intravenous insulin bolus regimens: a randomised controlled trial". Anaesthesia. 73 (3): 332–339. doi:10.1111/anae.14180. PMID 29230803.
  27. 27.0 27.1 27.2 Hulst AH, Visscher MJ, Godfried MB, Thiel B, Gerritse BM, Scohy TV; et al. (2020). "Liraglutide for perioperative management of hyperglycaemia in cardiac surgery patients: a multicentre randomized superiority trial". Diabetes Obes Metab. 22 (4): 557–565. doi:10.1111/dom.13927. PMC 7079116 Check |pmc= value (help). PMID 31749275.
  28. Nyström T, Gutniak MK, Zhang Q, Zhang F, Holst JJ, Ahrén B; et al. (2004). "Effects of glucagon-like peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease". Am J Physiol Endocrinol Metab. 287 (6): E1209–15. doi:10.1152/ajpendo.00237.2004. PMID 15353407.
  29. 29.0 29.1 Palmer, Suetonia C; Tendal, Britta; Mustafa, Reem A; Vandvik, Per Olav; Li, Sheyu; Hao, Qiukui; Tunnicliffe, David; Ruospo, Marinella; Natale, Patrizia; Saglimbene, Valeria; Nicolucci, Antonio; Johnson, David W; Tonelli, Marcello; Rossi, Maria Chiara; Badve, Sunil V; Cho, Yeoungjee; Nadeau-Fredette, Annie-Claire; Burke, Michael; Faruque, Labib I; Lloyd, Anita; Ahmad, Nasreen; Liu, Yuanchen; Tiv, Sophanny; Millard, Tanya; Gagliardi, Lucia; Kolanu, Nithin; Barmanray, Rahul D; McMorrow, Rita; Raygoza Cortez, Ana Karina; White, Heath; Chen, Xiangyang; Zhou, Xu; Liu, Jiali; Rodríguez, Andrea Flores; González-Colmenero, Alejandro Díaz; Wang, Yang; Li, Ling; Sutanto, Surya; Solis, Ricardo Cesar; Díaz González-Colmenero, Fernando; Rodriguez-Gutierrez, René; Walsh, Michael; Guyatt, Gordon; Strippoli, Giovanni F M (2021). "Sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials". BMJ: m4573. doi:10.1136/bmj.m4573. ISSN 1756-1833.
  30. Umpierrez GE, Gianchandani R, Smiley D, Jacobs S, Wesorick DH, Newton C; et al. (2013). "Safety and efficacy of sitagliptin therapy for the inpatient management of general medicine and surgery patients with type 2 diabetes: a pilot, randomized, controlled study". Diabetes Care. 36 (11): 3430–5. doi:10.2337/dc13-0277. PMC 3816910. PMID 23877988.
  31. Pasquel FJ, Gianchandani R, Rubin DJ, Dungan KM, Anzola I, Gomez PC; et al. (2017). "Efficacy of sitagliptin for the hospital management of general medicine and surgery patients with type 2 diabetes (Sita-Hospital): a multicentre, prospective, open-label, non-inferiority randomised trial". Lancet Diabetes Endocrinol. 5 (2): 125–133. doi:10.1016/S2213-8587(16)30402-8. PMID 27964837.
  32. Vellanki P, Rasouli N, Baldwin D, Alexanian S, Anzola I, Urrutia M; et al. (2019). "Glycaemic efficacy and safety of linagliptin compared to a basal-bolus insulin regimen in patients with type 2 diabetes undergoing non-cardiac surgery: A multicentre randomized clinical trial". Diabetes Obes Metab. 21 (4): 837–843. doi:10.1111/dom.13587. PMC 7231260 Check |pmc= value (help). PMID 30456796.
  33. Abuannadi M, Kosiborod M, Riggs L, House JA, Hamburg MS, Kennedy KF; et al. (2013). "Management of hyperglycemia with the administration of intravenous exenatide to patients in the cardiac intensive care unit". Endocr Pract. 19 (1): 81–90. doi:10.4158/EP12196.OR. PMID 23186969.
  34. Kohl BA, Hammond MS, Cucchiara AJ, Ochroch EA (2014). "Intravenous GLP-1 (7-36) amide for prevention of hyperglycemia during cardiac surgery: a randomized, double-blind, placebo-controlled study". J Cardiothorac Vasc Anesth. 28 (3): 618–25. doi:10.1053/j.jvca.2013.06.021. PMID 24144627.
  35. Besch G, Perrotti A, Mauny F, Puyraveau M, Baltres M, Flicoteaux G; et al. (2017). "Clinical Effectiveness of Intravenous Exenatide Infusion in Perioperative Glycemic Control after Coronary Artery Bypass Graft Surgery: A Phase II/III Randomized Trial". Anesthesiology. 127 (5): 775–787. doi:10.1097/ALN.0000000000001838. PMID 28820780.
  36. Lipš M, Mráz M, Kloučková J, Kopecký P, Dobiáš M, Křížová J; et al. (2017). "Effect of continuous exenatide infusion on cardiac function and peri-operative glucose control in patients undergoing cardiac surgery: A single-blind, randomized controlled trial". Diabetes Obes Metab. 19 (12): 1818–1822. doi:10.1111/dom.13029. PMID 28581209.
  37. Kaneko S, Ueda Y, Tahara Y (2018). "GLP1 Receptor Agonist Liraglutide Is an Effective Therapeutic Option for Perioperative Glycemic Control in Type 2 Diabetes within Enhanced Recovery After Surgery (ERAS) Protocols". Eur Surg Res. 59 (5–6): 349–360. doi:10.1159/000494768. PMID 30537714.
  38. Buse JB, Wexler DJ, Tsapas A, Rossing P, Mingrone G, Mathieu C; et al. (2020). "Correction to: 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of diabetes (EASD)". Diabetologia. 63 (8): 1667. doi:10.1007/s00125-020-05151-2. PMID 32409867 Check |pmid= value (help).
  39. Thiruvenkatarajan V, Meyer EJ, Nanjappa N, Van Wijk RM, Jesudason D (2019). "Perioperative diabetic ketoacidosis associated with sodium-glucose co-transporter-2 inhibitors: a systematic review". Br J Anaesth. 123 (1): 27–36. doi:10.1016/j.bja.2019.03.028. PMID 31060732.
  40. Damman K, Beusekamp JC, Boorsma EM, Swart HP, Smilde TDJ, Elvan A; et al. (2020). "Randomized, double-blind, placebo-controlled, multicentre pilot study on the effects of empagliflozin on clinical outcomes in patients with acute decompensated heart failure (EMPA-RESPONSE-AHF)". Eur J Heart Fail. 22 (4): 713–722. doi:10.1002/ejhf.1713. PMID 31912605.
  41. Pasquel FJ, Klein R, Adigweme A, Hinedi Z, Coralli R, Pimentel JL; et al. (2015). "Metformin-associated lactic acidosis". Am J Med Sci. 349 (3): 263–7. doi:10.1097/MAJ.0b013e3182a562b7. PMID 24326619.
  42. Iyengar R, Franzese J, Gianchandani R (2018). "Inpatient Glycemic Management in the Setting of Renal Insufficiency/Failure/Dialysis". Curr Diab Rep. 18 (10): 75. doi:10.1007/s11892-018-1044-y. PMID 30112652.
  43. 43.0 43.1 Bolen S, Feldman L, Vassy J, Wilson L, Yeh HC, Marinopoulos S; et al. (2007). "Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus". Ann Intern Med. 147 (6): 386–99. doi:10.7326/0003-4819-147-6-200709180-00178. PMID 17638715.
  44. 44.0 44.1 Roberts A, James J, Dhatariya K, Joint British Diabetes Societies (JBDS) for Inpatient Care (2018). "Management of hyperglycaemia and steroid (glucocorticoid) therapy: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group". Diabet Med. 35 (8): 1011–1017. doi:10.1111/dme.13675. PMID 30152586.
  45. Stuart K, Adderley NJ, Marshall T, Rayman G, Sitch A, Manley S; et al. (2017). "Predicting inpatient hypoglycaemia in hospitalized patients with diabetes: a retrospective analysis of 9584 admissions with diabetes". Diabet Med. 34 (10): 1385–1391. doi:10.1111/dme.13409. PMID 28632918.
  46. Khalam A, Dilip C, Shinu C (2012). "Drug use evaluation of diabetes mellitus in hospitalized patients of a tertiary care referral hospital". J Basic Clin Physiol Pharmacol. 23 (4): 173–7. doi:10.1515/jbcpp-2012-0012. PMID 23072848.
  47. Pasquel FJ, Spiegelman R, McCauley M, Smiley D, Umpierrez D, Johnson R; et al. (2010). "Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients". Diabetes Care. 33 (4): 739–41. doi:10.2337/dc09-1748. PMC 2845017. PMID 20040658.
  48. Laesser CI, Cumming P, Reber E, Stanga Z, Muka T, Bally L (2019). "Management of Glucose Control in Noncritically Ill, Hospitalized Patients Receiving Parenteral and/or Enteral Nutrition: A Systematic Review". J Clin Med. 8 (7). doi:10.3390/jcm8070935. PMC 6678336 Check |pmc= value (help). PMID 31261760.
  49. 49.0 49.1 Boughton CK, Bally L, Martignoni F, Hartnell S, Herzig D, Vogt A; et al. (2019). "Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial". Lancet Diabetes Endocrinol. 7 (5): 368–377. doi:10.1016/S2213-8587(19)30061-0. PMC 6467839. PMID 30935872.
  50. Burt MG, Drake SM, Aguilar-Loza NR, Esterman A, Stranks SN, Roberts GW (2015). "Efficacy of a basal bolus insulin protocol to treat prednisolone-induced hyperglycaemia in hospitalised patients". Intern Med J. 45 (3): 261–6. doi:10.1111/imj.12680. PMID 25565560.
  51. 51.0 51.1 Khowaja A, Alkhaddo JB, Rana Z, Fish L (2018). "Glycemic Control in Hospitalized Patients with Diabetes Receiving Corticosteroids Using a Neutral Protamine Hagedorn Insulin Protocol: A Randomized Clinical Trial". Diabetes Ther. 9 (4): 1647–1655. doi:10.1007/s13300-018-0468-3. PMC 6064602. PMID 29961246.
  52. Brady V, Thosani S, Zhou S, Bassett R, Busaidy NL, Lavis V (2014). "Safe and effective dosing of basal-bolus insulin in patients receiving high-dose steroids for hyper-cyclophosphamide, doxorubicin, vincristine, and dexamethasone chemotherapy". Diabetes Technol Ther. 16 (12): 874–9. doi:10.1089/dia.2014.0115. PMC 4241952. PMID 25321387.
  53. Dhatariya K, Levy N, Kilvert A, Watson B, Cousins D, Flanagan D; et al. (2012). "NHS Diabetes guideline for the perioperative management of the adult patient with diabetes". Diabet Med. 29 (4): 420–33. doi:10.1111/j.1464-5491.2012.03582.x. PMID 22288687.
  54. Fayfman M, Davis G, Duggan EW, Urrutia M, Chachkhiani D, Schindler J; et al. (2018). "Sitagliptin for prevention of stress hyperglycemia in patients without diabetes undergoing general surgery: A pilot randomized study". J Diabetes Complications. 32 (12): 1091–1096. doi:10.1016/j.jdiacomp.2018.08.014. PMC 6668912 Check |pmc= value (help). PMID 30253968.
  55. Davis GM, Galindo RJ, Migdal AL, Umpierrez GE (2020). "Diabetes Technology in the Inpatient Setting for Management of Hyperglycemia". Endocrinol Metab Clin North Am. 49 (1): 79–93. doi:10.1016/j.ecl.2019.11.002. PMC 7453786 Check |pmc= value (help). PMID 31980123.
  56. Singh LG, Satyarengga M, Marcano I, Scott WH, Pinault LF, Feng Z; et al. (2020). "Reducing Inpatient Hypoglycemia in the General Wards Using Real-time Continuous Glucose Monitoring: The Glucose Telemetry System, a Randomized Clinical Trial". Diabetes Care. 43 (11): 2736–2743. doi:10.2337/dc20-0840. PMC 7576426 Check |pmc= value (help). PMID 32759361 Check |pmid= value (help).
  57. Fortmann AL, Spierling Bagsic SR, Talavera L, Garcia IM, Sandoval H, Hottinger A; et al. (2020). "Glucose as the Fifth Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Hospital Setting". Diabetes Care. 43 (11): 2873–2877. doi:10.2337/dc20-1016. PMC 7576427 Check |pmc= value (help). PMID 32855160 Check |pmid= value (help).
  58. Galindo RJ, Aleppo G, Klonoff DC, Spanakis EK, Agarwal S, Vellanki P; et al. (2020). "Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic". J Diabetes Sci Technol. 14 (4): 822–832. doi:10.1177/1932296820932903. PMC 7673156 Check |pmc= value (help). PMID 32536205 Check |pmid= value (help).
  59. Montero AR, Dubin JS, Sack P, Magee MF (2019). "Future technology-enabled care for diabetes and hyperglycemia in the hospital setting". World J Diabetes. 10 (9): 473–480. doi:10.4239/wjd.v10.i9.473. PMC 6748879 Check |pmc= value (help). PMID 31558981.
  60. Kannan S, Satra A, Calogeras E, Lock P, Lansang MC (2014). "Insulin pump patient characteristics and glucose control in the hospitalized setting". J Diabetes Sci Technol. 8 (3): 473–8. doi:10.1177/1932296814522809. PMC 4455446. PMID 24876608.
  61. Thompson B, Leighton M, Korytkowski M, Cook CB (2018). "An Overview of Safety Issues on Use of Insulin Pumps and Continuous Glucose Monitoring Systems in the Hospital". Curr Diab Rep. 18 (10): 81. doi:10.1007/s11892-018-1056-7. PMID 30120619.
  62. Thompson B, Korytkowski M, Klonoff DC, Cook CB (2018). "Consensus Statement on Use of Continuous Subcutaneous Insulin Infusion Therapy in the Hospital". J Diabetes Sci Technol. 12 (4): 880–889. doi:10.1177/1932296818769933. PMC 6134295. PMID 29681173.
  63. Umpierrez GE, Klonoff DC (2018). "Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital". Diabetes Care. 41 (8): 1579–1589. doi:10.2337/dci18-0002. PMC 6054505. PMID 29936424.
  64. Bally L, Thabit H, Hartnell S, Andereggen E, Ruan Y, Wilinska ME; et al. (2018). "Closed-Loop Insulin Delivery for Glycemic Control in Noncritical Care". N Engl J Med. 379 (6): 547–556. doi:10.1056/NEJMoa1805233. PMID 29940126.
  65. Bally L, Gubler P, Thabit H, Hartnell S, Ruan Y, Wilinska ME; et al. (2019). "Fully closed-loop insulin delivery improves glucose control of inpatients with type 2 diabetes receiving hemodialysis". Kidney Int. 96 (3): 593–596. doi:10.1016/j.kint.2019.03.006. PMID 31133457.

Template:WHTemplate:WS