院内高血糖的处理ppt课件.pptVIP

Hyperglycemia Management in the Hospital;Hyperglycemia has been defined as any blood glucose 140 mg/dl (7.8 mmol/l). Levels that are significantly and persistently above this may require treatment in hospitalized patients. In patients without a previous diagnosis of diabetes, elevated blood glucose may be due to “stress hyperglycemia,” a condition that can be established by a review of prior records or measurement of an A1C. A1C values 6.5% suggest that diabetes preceded hospitalization (359).;The Increasing Rate of Diabetes Among Hospitalized Patients;Hyperglycemia in Hospitalized Patients;Prevalence of Hyperglycemia in 181 Cardiac Patients Without Known Diabetes ;Hyperglycemia Is an Independent Marker of Inpatient Mortality in Patients With Undiagnosed Diabetes;Hyperglycemia in Hospitalized Patients;Hospital Costs Account for Majority of Total Costs of Diabetes;Benefits of Improved Glucose Control in the Hospital;;;;;;Mortality of DM Patients Undergoing CABG;Costs of Hyperglycemia in the Hospital;Intensive Insulin Therapy in Critically Ill Patients—Morbidity and Mortality Benefits;P=0.0009 ;Hyperglycemia and Hospital Mortality 1826 consecutive ICU patients 10/99 thru 4/02, Stamford CT;Intensive Insulin Management in Medical-Surgical ICU (n = 1600);Glycemic threshold in ICU Patients;What About Medical Patients?;Cardiovascular RiskMortality After MI Reduced by Insulin Therapy in the DIGAMI Study;Other Medical Conditions;Target blood glucose in mg/dL ;● All patients with diabetes admitted tothe hospital should have their diabetesclearly identified in the medical record.(E)● All patients with diabetes should havean order for blood glucose monitoring,with results available to all members ofthe health care team. (E);;● Critically ill patients: Insulin therapy should be initiated for treatment of persistent hyperglycemia starting at a threshold of 180 mg/dl (10 mmol/ l). Once insulin therapy is started, a glucose range