The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described. Due to the increased prevalence and life expectancy of patients with type 1 diabetes, a growing number of these patients require hospitalization every year. Inpatient diabetes management is complex and is best provided by a multidisciplinary diabetes team. In the absence of such resource, providers and health care staff must become familiar with the features of this condition to avoid complications such as severe hyperglycemia, ketoacidosis, hypoglycemia, or glycemic variability. We reviewed most recent guidelines and relevant literature in the topic to provide practical recommendations for the inpatient management of patients with T1D.
Diabetes mellitus and open heart surgery. A simple, practical closed-loop insulin infusion system for blood glucose control
Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year
Hospitalizations for people with type 1 and type 2 diabetes compared with the nondiabetic population of Tayside, Scotland: a retrospective cohort study of resource use
Hospitalization among diabetic children and adolescents and the general population in Germany. German Working Group for Pediatric Diabetology
Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting
Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate)
Use of continuous subcutaneous insulin infusion (insulin pump) therapy in the hospital setting: proposed guidelines and outcome measures
Diabetes care in hospitalized noncritically ill patients: More evidence for clinical inertia and negative therapeutic momentum
Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review
Comparison of inpatient insulin regimens with detemir plus aspart versus neutral protamine hagedorn plus regular in medical patients with type 2 diabetes
Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline
Analysis of guidelines for basal-bolus insulin dosing: basal insulin, correction factor, and carbohydrate-to-insulin ratio.
Continuous subcutaneous insulin infusion (insulin pump) therapy can be safely used in the hospital in select patients.
Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data
American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control
Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study
Perioperative intensive insulin therapy using artificial endocrine pancreas in patients undergoing pancreatectomy
Continuous postoperative blood glucose monitoring and control by artificial pancreas in patients having pancreatic resection: a prospective randomized clinical trial
Use of continuous glucose monitoring to estimate insulin requirements in patients with type 1 diabetes mellitus during a short course of prednisone
Use of continuous subcutaneous insulin infusion (insulin pump) therapy in the hospital: a review of one institution's experience
A prospective evaluation of insulin dosing recommendations in patients with type 1 diabetes at near normal glucose control: bolus dosing
Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients
Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions
A comparison study of continuous insulin infusion protocols in the medical intensive care unit: computer-guided vs. standard column-based algorithms
Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline
Subcutaneous administration of glargine to diabetic patients receiving insulin infusion prevents rebound hyperglycemia
What do we need beyond hemoglobin A1c to get the complete picture of glycemia in people with diabetes?
Transitioning insulin pump therapy from the outpatient to the inpatient setting: a review of 6 years' experience with 253 cases
Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients
Role of diabetes type in perioperative outcomes after hip and knee arthroplasty in the United States
Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study
Evaluation of a novel artificial pancreas: closed loop glycemic control system with continuous blood glucose monitoring
Enhancing insulin-use safety in hospitals: Practical recommendations from an ASHP Foundation expert consensus panel
Accuracy of subcutaneous continuous glucose monitoring in critically ill adults: improved sensor performance with enhanced calibrations
Perioperative intensive insulin therapy using an artificial endocrine pancreas with closed-loop glycemic control system: the effects of no hypoglycemia
Continuous glucose monitoring in newborn infants: how do errors in calibration measurements affect detected hypoglycemia?
Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial
Performance of the Medtronic Sentrino continuous glucose management (CGM) system in the cardiac intensive care unit
Insulin pump risks and benefits: a clinical appraisal of pump safety standards, adverse event reporting and research needs. A joint statement of the European Association for the Study of Diabetes and the American Diabetes Association Diabetes Technology Working Group
Effectiveness of a multidisciplinary team approach to the prevention of readmission for acute glycaemic events
Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study
Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry
A case of perioperative glucose control by using an artificial pancreas in a patient with glycogen storage disease
Comparison of Basal-Bolus and Premixed Insulin Regimens in Hospitalized Patients With Type 2 Diabetes
Round Table Discussion on Inpatient Use of Continuous Glucose Monitoring at the International Hospital Diabetes Meeting
Comparison between a novel and conventional artificial pancreas for perioperative glycemic control using a closed-loop system
USE OF A COMPUTER-GUIDED GLUCOSE MANAGEMENT SYSTEM TO IMPROVE GLYCEMIC CONTROL AND ADDRESS NATIONAL QUALITY MEASURES: A 7-YEAR, RETROSPECTIVE OBSERVATIONAL STUDY AT A TERTIARY CARE TEACHING HOSPITAL.
Glycemic Management in the Operating Room: Screening, Monitoring, Oral Hypoglycemics, and Insulin Therapy
Continuous Subcutaneous Insulin Infusions vs. Multiple Daily Injections of Insulin in Hospitalized Patients: Glycemic Trends in the First 24 Hours of Admission.
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