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The case for supporting inpatient glycemic control programs now: The evidence and beyond
Author(s) -
Braithwaite Susan S.,
Magee Michelle,
Sharretts John M.,
Schnipper Jeffrey L.,
Amin Alpesh,
Maynard Gregory
Publication year - 2008
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.350
Subject(s) - medicine , glycemic , hospital medicine , medline , intensive care medicine , real world evidence , control (management) , family medicine , diabetes mellitus , endocrinology , artificial intelligence , political science , law , computer science
8 Department of Medicine, Division of Hospital Medicine, University of California San Diego, San Diego, California. M edical centers are faced with multiple competing priorities when deciding how to focus their improvement efforts and meet the ever expanding menu of publicly reported and regulatory issues. In this article we expand on the rationale for supporting inpatient glycemic control programs as a priority that should be moved near the top of the list. We review the evidence for establishing glycemic range targets, and also review the limitations of this evidence, acknowledging, as does the American Diabetes Association (ADA), that in ‘‘both the critical care and non-critical care venue, glycemic goals must take into account the individual patient’s situation as well as hospital system support for achieving these goals.’’ We emphasize that inpatient glycemic control programs are needed to address a wide variety of quality and safety issues surrounding the care of the inpatient with diabetes and hyperglycemia, and we wish to elevate the dialogue beyond arguments surrounding adoption of one glycemic target versus another. The Society of Hospital Medicine Glycemic Control Task Force members are not in unanimous agreement with the American Association of Clinical Endocrinologists (AACE)/ADA inpatient glycemic targets. However, we do agree on several other important points, which we will expand on in this article: