Glycemic Care in Hospitalized Patients with Diabetes: Current Views and Future Perspectives

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 11350

Special Issue Editor

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism at Penn State University, Milton S Hershey Medical Center, Hershey, PA, USA
Interests: diabetes management; glycemic control; quality improvement; health informatics; clinical decision support; health systems science; health disparities; diabetes education; practice performance

Special Issue Information

Dear Colleagues,

Dysglycemia contributes to morbidity and mortality in acutely ill patients.  Hospital glycemic control has important implications on outcomes. Evolving systems of practice, advancements in technology, treatment alternatives, and the current global pandemic are driving new knowledge. In this special issue of Diabetology, authors will contribute towards scientific evidence in various domains of inpatient diabetes care and glycemic management. Manuscripts will focus on epidemiology, treatment, complications, system processes, care delivery, technology, health informatics, decision-making, quality improvement, practice performance, education, competencies, and Covid 19. Contributions may derive from qualitative and/or quantitative research. Authors will feature their current work and future perspectives related to glycemic care in the hospital through original research, reviews, case reports, conceptual models and perspectives

Prof. Dr. Ariana Pichardo-Lowden
Guest Editor

Manuscript Submission Information

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Keywords

  • hospital diabetes care
  • inpatient glycemic control
  • hyperglycemia in the hospital
  • hypoglycemia in the hospital
  • inpatient diabetes technology
  • health systems science
  • health information technology
  • clinical decision support
  • glucose monitoring in the hospital
  • quality improvement
  • care transitions
  • COVID-19

Published Papers (2 papers)

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Research

7 pages, 703 KiB  
Communication
Managing Hospitalized Patients Taking SGLT2 Inhibitors: Reducing the Risk of Euglycemic Diabetic Ketoacidosis
by Julia Selwyn and Ariana R. Pichardo-Lowden
Diabetology 2023, 4(1), 86-92; https://doi.org/10.3390/diabetology4010010 - 21 Feb 2023
Cited by 3 | Viewed by 8179
Abstract
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are emerging as an important therapy not only for type 2 diabetes (T2DM), but also for heart disease and kidney disease. As these medicines gain acceptance, the number of hospitalized patients receiving them is likely to rise. During clinical [...] Read more.
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are emerging as an important therapy not only for type 2 diabetes (T2DM), but also for heart disease and kidney disease. As these medicines gain acceptance, the number of hospitalized patients receiving them is likely to rise. During clinical trials, SGLT2 inhibitors were noted to have a potential risk for diabetic ketoacidosis (DKA), particularly DKA with relatively normal blood glucose levels, ‘euglycemic DKA’. Similar to DKA that is not associated with SGLT2 inhibitors, most of these events seem to be related to acute illnesses or other changes in a patient’s medications or self-management circumstances. This creates a need among hospital providers to create strategies to prevent DKA in their hospitalized patient and guidance on monitoring and treating euglycemic DKA. Our combined experience concerning this phenomenon has given a great deal of insight into this problem and the knowledge needed to improve patient care, by augmenting patient education, inpatient surveillance, and early treatment for euglycemic DKA. Full article
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8 pages, 241 KiB  
Article
Evaluating the Influence of Mood and Stress on Glycemic Variability in People with T1DM Using Glucose Monitoring Sensors and Pools
by Jose Manuel Velasco, Marta Botella-Serrano, Almudena Sánchez-Sánchez, Aranzazu Aramendi, Remedios Martínez, Esther Maqueda, Oscar Garnica, Sergio Contador, Juan Lanchares and José Ignacio Hidalgo
Diabetology 2022, 3(2), 268-275; https://doi.org/10.3390/diabetology3020018 - 11 Apr 2022
Viewed by 2412
Abstract
Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood and stress influence blood glucose levels and variability. Material and Methods: Continuous glucose monitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucose [...] Read more.
Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood and stress influence blood glucose levels and variability. Material and Methods: Continuous glucose monitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucose values were recorded every 15 min. A daily survey was conducted through Google Forms, collecting information on mood and stress. The day was divided into six slots of 4-h each, asking the patient to assess each slot in relation to mood (sad, normal or happy) and stress (calm, normal or nervous). Different measures of glycemic control (arithmetic mean and percentage of time below/above the target range) and variability (standard deviation, percentage coefficient of variation, mean amplitude of glycemic excursions and mean of daily differences) were calculated to relate the mood and stress perceived by patients with blood glucose levels and glycemic variability. A hypothesis test was carried out to quantitatively compare the data groups of the different measures using the Student’s t-test. Results: Statistically significant differences (p-value < 0.05) were found between different levels of stress. In general, average glucose and variability decrease when the patient is calm. There are statistically significant differences (p-value < 0.05) between different levels of mood. Variability increases when the mood changes from sad to happy. However, the patient’s average glucose decreases as the mood improves. Conclusions: Variations in mood and stress significantly influence blood glucose levels, and glycemic variability in the patients analyzed with type 1 diabetes mellitus. Therefore, they are factors to consider for improving glycemic control. The mean of daily differences does not seem to be a good indicator for variability. Full article
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