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Intravenous (IV) insulin infusion is a standard protocol for treating critically ill hospitalized patients with hyperglycemia. However, once glucose levels stabilize, patients may be transitioned to subcutaneous (SubQ) insulin injections. The transition from IV to SubQ dosing involves many variables and can be difficult to achieve without a few bumps along the way. While some hospitals follow standard transition protocols,...

When it comes to managing glucose levels in the hospital, the pharmacist can play an active role and, with broad expertise in medication management, make a unique contribution. Pharmacists are well informed of the risks associated with hyperglycemia and the benefits of tighter glycemic control, as well as the impact of the all-too-common hyperglycemia to hypoglycemia swing. If a patient...

Concerned about its inability to stabilize glucose levels in its most acutely ill patients, Wilson Memorial Hospital, a 71-bed community hospital, engaged a well-known glycemic benchmarking service. The service found the hospital in the lowest quartile of benchmarked hospitals nationwide. Knowing that hyperglycemia correlates with poor clinical outcomes and mortality in patients with and without a history of diabetes, naturally...