Diabetes Management in Hospital Settings

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What is the primary reason for providing enough insulin to keep blood glucose levels below 10 mmol/L in diabetes patients?

To increase the patient's life expectancy

To improve the effectiveness of nutritional insulin

To prevent hyperglycemia symptoms (correct)

To reduce the risk of hypoglycemia

Why is the use of sliding scales as a sole method for maintaining glycemic control discouraged?

Because it is too expensive

Because it lacks a systematic approach to glycemic control (correct)

Because it is too time-consuming

Because it is not effective in preventing hypoglycemia

What should be done if a patient is not eating and is scheduled to receive nutritional insulin?

Halt all insulin administration until the patient starts eating

Administer the nutritional insulin as scheduled

Replace scheduled nutritional insulin with correctional doses (correct)

Monitor blood glucose levels more frequently

What is the current status of continuous glucose monitoring in hospitals?

It is an unproven but promising area of research Signup and view all the answers

Why might patients with extensive comorbidity and short life expectancy require a higher target range for blood glucose levels?

Because they may not benefit from tight glycemic control Signup and view all the answers

What is the importance of proper insulin dosing in ICU patients?

It is crucial in managing mortality Signup and view all the answers

What is a primary factor contributing to the rapid increase in glycemic shifts in hospitalized patients?

Changes in diet and fasting from procedures Signup and view all the answers

What is the primary consequence of increased fluctuations in blood glucose levels in hospitalized patients?

Increased morbidity and mortality rates in critical care, acute MI, and surgery patients Signup and view all the answers

What is the most effective method of insulin dosing compared to sliding scale insulin in hospitalized patients?

Initiation of scheduled basal/bolus insulin Signup and view all the answers

What is the primary benefit of scheduled basal/bolus insulin in hospitalized patients?

Reducing blood glucose variability and allowing patients to achieve normoglycemia Signup and view all the answers

What is the primary outcome of effective insulin therapy in hospitalized patients?

Improved clinical outcomes and shorter lengths of hospital stay Signup and view all the answers

What is the primary goal of effective insulin therapy in hospitalized patients?

Avoiding hyperglycemia, hypoglycemia, and reducing blood glucose variability Signup and view all the answers

What is the primary concern associated with aggressive glucose control in critically ill patients?

Higher incidence of hypoglycemia offsetting potential mortality benefit Signup and view all the answers

What is the correlation between mean blood glucose levels and mortality in a diverse population of critically ill patients?

U-shaped correlation with increased mortality at higher glucose levels Signup and view all the answers

What is the effect of every 1% increase in mean blood glucose above 4.6 mmol/L on mortality in patients receiving insulin?

17% increase in mortality Signup and view all the answers

Which factor is often overlooked in the management of hyperglycemia in hospitalized patients?

Use of enteral and parenteral corticosteroids Signup and view all the answers

What is the primary challenge in insulin dosing in hospital settings?

All of the above Signup and view all the answers

What is the estimated percentage of prescribed insulin doses that are either too high or too low?

Nearly 50% of prescribed insulin doses Signup and view all the answers

What is the recommended total daily dose of insulin for general medicine or surgery patients with stress hyperglycemia or poorly controlled type 2 diabetes?

0.5 units/kg Signup and view all the answers

What is the benefit of using basal insulin with correctional scale in hospitalized patients?

Improved glycemic control in patients with inadequate basal insulin secretion Signup and view all the answers

What is the primary reason for the failure to adjust insulin doses based on sliding scale coverage in hospitalized patients?