Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Diabetes Reports
Published in: Current Diabetes Reports 2/2014

01-02-2014 | Hospital Management of Diabetes (G Umpierrez, Section Editor)

Management of Patients with Type 1 Diabetes in the Hospital

Authors: Divya Yogi-Morren, M. Cecilia Lansang

Published in: Current Diabetes Reports | Issue 2/2014

Login to get access

Abstract

Managing a patient with type 1 diabetes mellitus can be challenging to the inpatient medical team. These patients require a continuous supply of exogenous insulin, and the omission of even a single dose can result in severe hyperglycemia and diabetic ketoacidosis. This article aims to equip the inpatient medical team with the knowledge and expertise required to care for these patients in the hospital, including transitioning from home to hospital, transitioning from the intravenous insulin infusion to the subcutaneous route, subcutaneous insulin dosing including the insulin pump, and transitioning back to home.
Literature
1.
2.
Onkamo P, Väänänen S, Karvonen M, Tuomilehto J. Worldwide increase in incidence of Type I diabetes—the analysis of the data on published incidence trends. Diabetologia. 1999;42:1395–403.PubMedCrossRef
3.
4.
Lambert AP, Gillespie KM, Thomson G, et al. Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab. 2004;89:4037–43.PubMedCrossRef
5.
Umpierrez GE, Isaacs SD, Bazargan N, You X, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–82.PubMed
6.
Zerr KJ, Furnary AP, Grunkemeier GL, et al. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Ann Thorac Surg. 1997;63:356–61.PubMedCrossRef
7.
Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc. 2003;78:1471–8.PubMedCrossRef
8.
Williams LS, Rotich J, Qi R, Fineberg N, et al. Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology. 2002;59:67–71.PubMedCrossRef
9.
Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Critical Care Med. 2009;37:3001–9.CrossRef
10.
Tewari S, Kathuria A, Meier-Kriesche H-U, et al. Association between admission hyperglycemia and length of stay after renal transplantation. Endocr Pract. 2010;16:805–9.PubMedCrossRef
11.
The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. New Engl J Med. 1993;329:977–86.
12.
van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. New Engl J Med. 2001;345:1359–67.PubMedCrossRef
13.
Malmberg K, Rydén L, Efendic S, et al. 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.PubMedCrossRef
14.•
Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diab Care. 2011;34:256–61. Important paper on basal bolus insulin therapy.CrossRef
15.
Shogbon AO, Levy SB. Intensive glucose control in the management of diabetes mellitus and inpatient hyperglycemia. Am J Health Syst Pharm. 2010;67:798–805.PubMedCrossRef
16.
Jacobsen IB, Henriksen JE, Hother-Nielsen O, et al. Evidence-based insulin treatment in type 1 diabetes mellitus. Diabetes Res Clin Pract. 2009;86:1–10.PubMedCrossRef
17.
Standards of medical care in diabetes—2013. American Diabetes Association. Diab Care. 2013;36(Suppl 1):S11–66.
18.
Vella S, Buetow L, Royle P, et al. The use of metformin in type 1 diabetes: a systematic review of efficacy. Diabetologia. 2010;53:809–20.PubMedCrossRef
19.
Wu P, Inskeep K, Bowker-Kinley MM, Popov KM, et al. Mechanism responsible for inactivation of skeletal muscle pyruvate dehydrogenase complex in starvation and diabetes. Diabetes. 1999;48:1593–9.PubMedCrossRef
20.
Pang TTL, Narendran P. Addressing insulin resistance in Type 1 diabetes. Diabetic Med. 2008;25:1015–24.PubMedCrossRef
21.
Beales PE, Pozzilli P. Thiazolidinediones for the prevention of diabetes in the non-obese diabetic (NOD) mouse: implications for human type 1 diabetes. Diabetes Metab Res Rev. 2002;18:114–7.PubMedCrossRef
22.
Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:16–38.PubMedCrossRef
23.
Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353–69.PubMedCrossRef
24.
Clement S, Braithwaite SS, Magee MF, Ahmann A, et al. Management of diabetes and hyperglycemia in hospitals. Diab Care. 2004;27:553–91.CrossRef
25.
American College of Endocrinology and American Diabetes Association consensus statement on inpatient diabetes and glycemic control. Endocr Pract. 2006;12:458–68.
26.
Dates R, Origin DO. Medical policy No. 91516-R5. Medical errors: serious reportable events. 2006;91516:1–13.
27.
Vann MA. Perioperative management of ambulatory surgical patients with diabetes mellitus. Curr Opin Anesth. 2009;22:718–24.CrossRef
28.
Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes. Diab Care. 2009;32:1335–43. Important paper describing the presentation, pathogenesis, diagnosis, and management of DKA. CrossRef
29.
Beck RW, Tamborlane WV, Bergenstal RM, et al. The T1D Exchange clinic registry. J Clin Endocrinol Metab. 2012;97:4383–9.PubMedCrossRef
30.•
Pickup JC. Insulin-pump therapy for type 1 diabetes mellitus. New Engl J Med. 2012;366:1616–24. Important paper on insulin pump therapy in T1DM.PubMedCrossRef
31.
Grunberger G, Bailey TS, Cohen AJ, et al. Statement by the American Association of Clinical Endocrinologists Consensus Panel on insulin pump management. Endocr Pract. 2010;16:746–62.PubMedCrossRef
Metadata
Title
Management of Patients with Type 1 Diabetes in the Hospital
Authors
Divya Yogi-Morren
M. Cecilia Lansang
Publication date
01-02-2014
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 2/2014
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-013-0458-9

Other articles of this Issue 2/2014

Current Diabetes Reports 2/2014 Go to the issue

Diabetes and Pregnancy (CJ Homko, Section Editor)

Impact of Breastfeeding on Maternal Metabolism: Implications for Women with Gestational Diabetes

Pediatric Type 2 Diabetes (PS Zeitler, Section Editor)

Metabolic Basis of Ethnic Differences in Diabetes Risk in Overweight and Obese Youth

Diabetes and Pregnancy (CJ Homko, Section Editor)

The Relationship and Potential Mechanistic Pathways Between Sleep Disturbances and Maternal Hyperglycemia

Health Care Delivery Systems in Diabetes (D Wexler, Section Editor)

Implementing Community-Based Diabetes Programs: The Scripps Whittier Diabetes Institute Experience

Pediatric Type 2 Diabetes (PS Zeitler, Section Editor)

Nephropathy in Youth and Young Adults with Type 2 Diabetes

Pediatric Type 2 Diabetes (PS Zeitler, Section Editor)

Cardiovascular Risk in Children and Adolescents with Type 2 Diabetes Mellitus
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits