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Common Models Used for Inpatient Diabetes Management

  • Andjela T. Drincic
  • Padmaja Akkireddy
  • Jon T. Knezevich
Health Care Delivery Systems and Implementation in Diabetes (ME McDonnell and AR Sadhu, Section Editors)
  • 418 Downloads
Part of the following topical collections:
  1. Topical Collection on Health Care Delivery Systems and Implementation in Diabetes

Abstract

Purpose of Review

Diabetes affects about a third of all hospitalized patients and up to 50% of inpatients go on to experience hyperglycemia. Despite strong evidence supporting the importance of adequate glycemic control, as well detailed guidelines from major national organizations, many patients continue to have hypo- and hyperglycemia during their hospital stay. While this may be partially related to provider and patient-specific factors, system-based barriers continue to pose a major obstacle. Therefore, there is a need to go beyond merely discussing specific insulin protocols and provide guidance for effective models of care in the acute glycemic management of hospitalized patients.

Recent Findings

To date, there is limited data evaluating the various models of care for inpatient diabetes management in terms of efficacy or cost, and there is no summary on this topic guiding physicians and hospital administrators.

Summary

In this paper, four common models of inpatient diabetes care will be presented including those models led by the following: an endocrinologist(s), mid-level provider(s), pharmacist(s), and a virtual glucose management team. The authors will outline the intrinsic benefits as well as limitations of each model of care as well as cite supporting evidence, when available. Discussion pertaining to how a given model of care shapes and formulates a particular organization’s structured glucose management program (GMP) will be examined. Furthermore, the authors describe how the model of care chosen by an institution serves as the foundation for the creation of a GMP. Finally, the authors examine the critical factors needed for GMP success within an institution and outline the nature of hospital administrative support and accompanying reporting structure, the function of a multidisciplinary diabetes steering committee, and the role of the medical director.

Keywords

Models of care Diabetes Hospitalized patients Inpatient diabetes management Glucose management program Hospital infrastructure 

Notes

Compliance with Ethical Standards

Conflict of Interest

Andjela Drincic, Padmaja Akkireddy, and Jon Knezevich declare that they have no conflict of interest.

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 •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Andjela T. Drincic
    • 1
  • Padmaja Akkireddy
    • 1
  • Jon T. Knezevich
    • 2
  1. 1.Department of Internal Medicine: Diabetes, Endocrinology and MetabolismUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of Pharmaceutical and Nutrition CareUniversity of Nebraska Medical CenterOmahaUSA

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