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Controlling blood sugar in hospitalized patients saves lives

ard for meal schedules or the patient's sensitivity to insulin. This may cause dangerous highs and lows in the patient's blood sugar level. In other words, sliding scale insulin treatment is a method of correction, not control.

"Sliding scale insulin those are dirty words to an endocrinologist," Reynolds said. "It is reactive rather than proactive. Sliding scale insulin treatment puts a patient on a blood sugar level roller coaster, and it's a dangerous ride."

Under the new guidelines, nurses and physicians will follow detailed protocols based on a patient's condition and blood glucose level. For example, blood glucose levels in critically ill patients will be kept as close to 110 mg/dl as possible, most likely with intravenous insulin. Other improvements in patient care include:

  • So-called ADA Diets will be replaced with Consistent Carbohydrate diets, which help regulate blood sugar.
  • A diabetes education plan will be developed for each patient.
  • Follow-up testing will be planned for patients experiencing hyperglycemia while in the hospital but not diagnosed with diabetes.

"This is not an overnight change. It requires months of preparation and education," Reynolds said. "We'll follow outcomes and expect to see great improvements as a result of our hard work."

Nurses and other staff members will be attending in-service education sessions through April. An online learning module, designed by Dr. Reynolds, is available for physicians. In addition, staff across multiple units have been identified as "Champions" and will serve as experts on the topic.

The UK Chandler Medical Center will be providing its expertise to other hospitals in various ways. UK's Glycemic Control Program will likely be used as a model in hospitals across the state and beyond. For more information, or to make an appointment, contact the UK Division of Endocrinology and Molecular Medicine at 859-323-5575.


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Contact: Melanie Jackson
mpjack0@uky.edu
859-323-6363
University of Kentucky
4-Apr-2006


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