Conversion from Intravenous Insulin to Subcutaneous Insulin After Cardiovascular Surgery: Transition to Target Study

Shomali, Mansur; Herr, Daniel; Hill, Peter C.; Pehlivanova, Marieta; Sharretts, John M.; Magee, Michelle F.

doi:10.1089/dia.2010.0124

Cited by 28 publications

(27 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A relevant goal of this transition phase is to accurately determine a daily dose requirement that can be administered as basal/prandial/correctional or basalcorrectional insulin therapy depending upon the patient oral intake status. Similar to previously published recommendations [76][77][78] we suggest using 60-80% of the total daily calculated insulin requirement based on the final 6 h of the infusion rate. Other institutions have attained modest and safe control using a transition from IV to SQ insulin of 50% of the daily calculated dose [79].…”

Section: Management Of Hyperglycemia and Insulin Use In The Hospitalsupporting

confidence: 64%

Management of Hyperglycemia During the Perioperative Period

Pichardo-Lowden

Gabbay

2011

Curr Diab Rep

View full text Add to dashboard Cite

Hyperglycemia is frequently encountered in the inpatient setting and is distinctly associated with poor clinical outcomes. Recent literature suggests an association between stringent glycemic control and increased mortality, thus keeping optimal glycemic targets a relevant subject of debate. In the surgical population, hyperglycemia with or without diabetes mellitus may be unrecognized. Factors contributing to hyperglycemia in the hospital include critical illness, use of certain drugs, use of enteral or parenteral nutrition, and variability in oral or nutritional intake as can occur when patients are prepared for procedures or surgery. A sensible approach to managing hyperglycemia in this population includes preoperative recognition of diabetes mellitus and risks for inpatient hyperglycemia. Judicious control of glycemia during the pre-, intra-, and postoperative time periods with avoidance of hypoglycemia mandates the need for a strategy for patient management that extend to time of discharge. We review the consequences of uncontrolled perioperative hyperglycemia, discuss current clinical guidelines and recent controversies, and provide practical tools for glycemic control in the surgical population.

show abstract

Section: Management Of Hyperglycemia and Insulin Use In The Hospitalsupporting

confidence: 64%

Management of Hyperglycemia During the Perioperative Period

Pichardo-Lowden

Gabbay

2011

Curr Diab Rep

View full text Add to dashboard Cite

show abstract

“…In the ICU, intravenous infusion is the preferred route of insulin administration. When the patient is transitioned off intravenous insulin to subcutaneous therapy, precautions should be taken to prevent hyperglycemia escape (564,565). Outside of critical care units, scheduled subcutaneous insulin that delivers basal, nutritional, and correctional (supplemental) components is recommended.…”

Section: Antihyperglycemic Agents In Hospitalized Patientsmentioning

confidence: 99%

Standards of Medical Care in Diabetes—2014

2013

Diabetes Care

3,672

1,773

View full text Add to dashboard Cite

“…A patient with type 1 or type 2 diabetes being transitioned to outpatient subcutaneous insulin should receive subcutaneous basal insulin 2-4 h before the intravenous insulin is discontinued. Converting to basal insulin at 60-80% of the daily infusion dose has been shown to be effective (2,35,36). For patients continuing regimens with concentrated insulin in the inpatient setting, it is important to ensure the correct dosing by utilizing an individual pen and cartridge for each patient, meticulous pharmacist supervision of the dose administered, or other means (37,38).…”

Section: Transitioning Intravenous To Subcutaneous Insulinmentioning

confidence: 99%

14. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes—2018

2017

Diabetes Care

157

View full text Add to dashboard Cite

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

show abstract

Conversion from Intravenous Insulin to Subcutaneous Insulin After Cardiovascular Surgery: Transition to Target Study

Cited by 28 publications

References 7 publications

Management of Hyperglycemia During the Perioperative Period

Management of Hyperglycemia During the Perioperative Period

Standards of Medical Care in Diabetes—2014

14. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes—2018

Contact Info

Product

Resources

About