Skip to main content

Managing Diabetes in Hospital

  • Chapter
  • First Online:
Diabetes Management in Clinical Practice

Abstract

Emergency presentations in people with diabetes are relatively common. These include the traditional diabetic emergencies such as diabetic ketoacidosis, hyperglycaemic hyperosmolar syndrome and hypoglycaemia, as well as people with diabetes presenting with other medical emergencies such as a cerebrovascular accident (CVA) or an acute coronary syndrome (ACS). The evidence behind the clinical management of these emergencies is often inconclusive and there is considerable variation in clinical practice. This chapter aims to systematically review the published evidence behind the clinical management for the traditional diabetic emergencies and the common medical emergencies, as well as to critique existing guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Key References

  • Bektas F, Eray O, Sari R, Akbas H. Point of care blood ketone testing of diabetic patients in the emergency department. Endocr Res. 2004;30:395–402.

    Article  CAS  PubMed  Google Scholar 

  • Cheung NW, Wong VW, McLean M. The Hyperglycemia: Intensive Insulin Infusion in Infarction (HI-5) study: a randomized controlled trial of insulin infusion therapy for myocardial infarction. Diabetes Care. 2006;29:765–70.

    Article  CAS  PubMed  Google Scholar 

  • Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care. 2003;26:1902–12.

    Article  CAS  PubMed  Google Scholar 

  • Diaz R, Paolasso EA, Piegas LS, Tajer CD, Moreno MG, Corvalan R, Isea JE, Romero G. Metabolic modulation of acute myocardial infarction. The ECLA (Estudios Cardiologicos Latinoamerica) Collaborative Group. Circulation. 1998;98:2227–34.

    Article  CAS  PubMed  Google Scholar 

  • Gray CS, Hildreth AJ, Sandercock PA, O'Connell JE, Johnston DE, Cartlidge NE, Bamford JM, James OF, Alberti KG. Glucose-potassium-insulin infusions in the management of post-stroke hyperglycaemia: the UK Glucose Insulin in Stroke Trial (GIST-UK). Lancet Neurol. 2007;6:397–406.

    Article  CAS  PubMed  Google Scholar 

  • Joint British Diabetes Societies Inpatient Care Group. Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes. www.diabetes.nhs.uk/document.php?o=3766. Accessed 14 Aug 2013.

  • Joint British Diabetes Societies Inpatient Care Group. The hospital management of hypoglycaemia in adults with diabetes mellitus. 2010. http://www.diabetes.nhs.uk/document.php?o=217. Accessed 14 Aug 2013.

  • Joint British Diabetes Societies Inpatient Care Group. The management of diabetic ketoacidosis in adults. 2010. http://www.bsped.org.uk/clinical/docs/DKAManagementOfDKAinAdultsMarch20101.pdf. Accessed 14 Aug 2013.

  • Joint British Diabetes Societies Inpatient Care Group. The management of the hyperglycaemic hyperosmolar state (HHS) in adults with diabetes. www.diabetes.nhs.uk/document.php?o=3778. Accessed 14 Aug 2013.

  • Malmberg K, Ryden L, Efendic S, Herlitz J, Nicol P, Waldenstrom A, Wedel H, Welin L. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year. J Am Coll Cardiol. 1995;26:57–65.

    Article  CAS  PubMed  Google Scholar 

  • Malmberg K, Ryden L, Wedel H, Birkeland K, Bootsma A, Dickstein K, Efendic S, Fisher M, Hamsten A, Herlitz J, Hildebrandt P, MacLeod K, Laakso M, Torp-Pedersen C, Waldenstrom A. Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity. Eur Heart J. 2005;26:650–61.

    Article  CAS  PubMed  Google Scholar 

  • Moore C, Woollard M. Dextrose 10 % or 50 % in the treatment of hypoglycaemia out of hospital? A randomised controlled trial. Emerg Med J. 2005;22:512–5.

    Article  CAS  PubMed  Google Scholar 

  • Morris LR, Murphy MB, Kitabchi AE. Bicarbonate therapy in severe diabetic ketoacidosis. Ann Intern Med. 1986;105:836–40.

    Article  CAS  PubMed  Google Scholar 

  • Nyenwe EA, Kitabchi AE. Evidence-based management of hyperglycemic emergencies in diabetes mellitus. Diabetes Res Clin Pract. 2011;94:340–51.

    Article  PubMed  Google Scholar 

  • The National Diabetes Inpatient Audit. 2012. http://www.diabetes.nhs.uk/information_and_data/diabetes_audits/national_diabetes_inpatient_audit/. Accessed 14 Aug 2013.

  • Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Hyperglycemic crises in urban blacks. Arch Intern Med. 1997;157:669–75.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. S. Bobby Huda MBChB, MRCP, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Huda, M.S.B. (2014). Managing Diabetes in Hospital. In: Chowdhury, T. (eds) Diabetes Management in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-4869-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4869-2_6

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4868-5

  • Online ISBN: 978-1-4471-4869-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics