Inpatient Glucose Management: Part 2

ADA and Joint Commission Guidelines for Best Practices

In part 1 of this series, we explained the risks and complications associated with inpatient glucose control. We learned that occurrences include hyperglycemia, hypoglycemia, poor treatment and/or lack of control, and hospital-acquired conditions.

The American Diabetes Association (ADA) and The Joint Commission have created recommendations for diabetes care in the hospital. Some of the best practices include:

• Insulin – The preferred method of glycemic control in the hospital setting.
• Sliding scale – This retrospective method of insulin dosing is strongly discouraged in the hospital setting as the sole method of treatment.
• Glucose range – Once insulin therapy begins, a target glucose range of 140-180 mg/dL (7.8-10.0 mmol/L) is recommended for most critically ill and non-critically ill patients.
• Stringent targets – The target range of 110-140 mg/dL is appropriate for select critically ill patients without increasing the risk of hypoglycemia.

In part 3 of this series, we will uncover the facts behind the positive outcomes of inpatient glucose control.