期刊
LANCET DIABETES & ENDOCRINOLOGY
卷 9, 期 3, 页码 174-188出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S2213-8587(20)30381-8
关键词
-
资金
- US National Institutes of Health [K23GM128221-03, P30DK111024, P30DK111024-05S1, UL1TR002378-04, 1P30DK111024-05]
Hyperglycaemia in hospitalized patients, regardless of diabetes status, is associated with increased morbidity, mortality, and healthcare costs. Insulin therapy is recommended for inpatient management, with various non-insulin drug combinations also showing potential benefits for appropriate glycemic control. Ongoing research is exploring the impact of emerging diabetes technologies and remote inpatient diabetes management during the COVID-19 pandemic.
Hyperglycaemia in people with and without diabetes admitted to the hospital is associated with a substantial increase in morbidity, mortality, and health-care costs. Professional societies have recommended insulin therapy as the cornerstone of inpatient pharmacological management. Intravenous insulin therapy is the treatment of choice in the critical care setting. In non-intensive care settings, several insulin protocols have been proposed to manage patients with hyperglycaemia; however, meta-analyses comparing different treatment regimens have not clearly endorsed the benefits of any particular strategy. Clinical guidelines recommend stopping oral antidiabetes drugs during hospitalisation; however, in some countries continuation of oral antidiabetes drugs is commonplace in some patients with type 2 diabetes admitted to hospital, and findings from clinical trials have suggested that non-insulin drugs, alone or in combination with basal insulin, can be used to achieve appropriate glycaemic control in selected populations. Advances in diabetes technology are revolutionising day-to-day diabetes care and work is ongoing to implement these technologies (ie, continuous glucose monitoring, automated insulin delivery) for inpatient care. Additionally, transformations in care have occurred during the COVID-19 pandemic, including the use of remote inpatient diabetes management-research is needed to assess the effects of such adaptations.
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