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Current Diabetes Reports

, 19:110 | Cite as

Timing of Insulin with Meals in the Hospital: a Systems Improvement Approach

  • Kathleen DunganEmail author
Health Care Delivery Systems and Implementation in Diabetes (ME McDonnell and AR Sadhu, Section Editors)
  • 15 Downloads
Part of the following topical collections:
  1. Topical Collection on Health Care Delivery Systems and Implementation in Diabetes

Abstract

Purpose of Review

Coordination of glucose monitoring, mealtimes, and insulin delivery in the hospital is complex, involving interactions between multiple key agents and overlapping workflows. The purpose of this review is to evaluate the scope of the problem as well as to assess evidence for interventions.

Recent Findings

In recent years, there has been an emphasis on systems-based approaches which address multiple contributing components of the problem at once in an effort to more seamlessly integrate workflows. Technological advances, such as decision support systems and advances in automated insulin delivery, and strategies that minimize the need for complex insulin regimens hold promise for future study.

Summary

Evaluation of the coordination of insulin delivery is limited by a lack of standardized metrics and systematically collected mealtimes. Nevertheless, successful efforts include system-wide multicomponent interventions, though advances in therapeutic approaches may be of value.

Keywords

Hospital Diabetes Hyperglycemia Inpatient Meals Prandial insulin 

Notes

Compliance with Ethical Standards

Conflict of Interest

Kathleen Dungan reports research support from Eli Lilly, Sanofi Aventis, and Novo Nordisk; consulting activities with Eli Lilly, Mannkind; and royalties from UptoDate, DKBmed, and Elsevier.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes and MetabolismThe Ohio State UniversityColumbusUSA

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