Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum

Mathioudakis, Nestoras; Bashura, Holly; Boyer, LaPricia Lewis; Langan, Susan; Padmanaban, Bama S; Fayzullin, Shamil; Sokolinsky, Sam; Golden, Sherita Hill

doi:10.1177/2382120519861342

Cited by 5 publications

(2 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research shows that physicians find both time and lack of knowledge/resources to be a barrier to providing nutritional counseling to patients. 10 Since the Altman Rule can be shared and explained with very little time and without extensive nutritional knowledge, it meets these needs.…”

Section: Discussionmentioning

confidence: 99%

Is the Altman Rule a proxy for glycemic load?

Dong

2023

The Journal of Family Practice

View full text Add to dashboard Cite

The evidence supports patient use of this simple equation to evaluate the nutrition labels of packaged carbohydrate foods in the grocery aisle in order to make healthier decisions. ABSTRACTu Background: The Altman Rule, a simple tool for consumers seeking to make healthier packaged food choices at the point of sale, applies to packaged carbohydrates. According to the Altman Rule, a food is a healthier option if it has at least 3 g of fiber per serving and the grams of fiber plus the grams of protein exceed the grams of sugar per serving. This study sought to evaluate whether the Altman Rule is a valid proxy for glycemic load (GL).u Methods: We compared the binary outcome of whether a food item meets the Altman Rule with the GL of all foods categorized as cereals, chips, crackers, and granola bars in the Nutrition Data System for Research Database (University of Minnesota, Version 2010). We examined the percentage of foods in low-, medium-, and high-GL categories that met the Altman Rule.u Results: There were 1235 foods (342 cereals, 305 chips, 379 crackers, and 209 granola bars) in this analysis. There was a significant relationship between the GL of foods and the Altman Rule (P < .001) in that most low-GL (68%), almost half of medium-GL (48%), and very few high-GL (7%) foods met the criteria of the rule.

show abstract

Section: Discussionmentioning

confidence: 99%

Is the Altman Rule a proxy for glycemic load?

Dong

2023

The Journal of Family Practice

View full text Add to dashboard Cite

show abstract

“…The physician's omissions of hyperglycemia and impaired medication timing due to hospital system are important reasons that impact the management of hospitalized patients 7,8 . While there have been numerous publications on how to improve the management of glucose excursions in hospitalized patients, available systems to date appear to have fallen short of achieving optimal results [9][10][11][12][13] . Although diabetes management guidelines for inpatient diabetes advise the development and use of inpatient blood glucose monitoring systems, no gold standard models or systems presently exist.…”

Section: Introductionmentioning

confidence: 99%

Hospital hyperglycemia: Status Investigation and Effect of a Real-time Glycemic Alert System

Cao

Bernet

Liu

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUND Hospital hyperglycemia is common and associated with potential adverse outcomes. A Hospital-wide Mobile Phone Alert (HMA) system was built to achieve real time glucose monitoring with warnings for glucose excursions. This study investigated the status of glucose control and evaluated the impact of HMA system on inpatient glycemia management. METHODS Inpatients with hyperglycemia hospitalized between 1 January, 2017 and 31 December, 2018 were identified excluding those < 18 years of age. The HMA system was activated on 1 October, 2017. It sent real time cellphone warning messages to the patient’s designated team physician whenever glucose levels > 10 mmol/L or < 3 mmol/L were detected. A serum glucose > 7.8 mmol/L was defined as hospital hyperglycemia (HH), and > 10 mmol/L was defined as significant HH (SHH). Glucose excursions before and after the HMA system was instituted were compared. RESULTS The incidence of HH, SHH and hypoglycemia was 26.1%, 12.8% and 2.5%, respectively. With the HMA system, the monthly glucose related consultation rate for all inpatients increased 65.9%. The rate of HH glucose amount/ total glucose amount improved with the HMA system, being lower than pre HMA system activation for the surgical wards (15.8 ± 4.7% vs 21.1 ± 6.1%，p<0.05). CONCLUSIONS In this study, one third of inpatients were noted to experience hyperglycemia. Real time cellphone warning messages to the patient’s designated team physician can improve consultation utilization for blood glucose excursions. The alert system was found to reduce the incidence of hyperglycemia on surgical wards.

show abstract

Incidence and control of steroid-induced hyperglycaemia in hospitalised patients at a tertiary care centre for lung diseases

Gruban

Kos

2021

Pharmacol. Rep

View full text Add to dashboard Cite

Background The aim of this study was to determine the incidence of steroid-induced hyperglycaemia (SIH) in patients hospitalised at the tertiary centre for lung diseases, to assess glycaemic control during hospitalisation, and to determine the factors associated with the control of SIH. Methods A 4-month retrospective study was conducted. All patients who received systemic glucocorticoids for ≥ 2 days during hospitalisation, with ≥ 2 elevated blood glucose (BG) readings, were included in the analysis. SIH control was determined by mean BG levels, the number and proportion of elevated and pronouncedly elevated BG readings, and the number of hypoglycaemic events. Results 60 of 283 patients (21.2%) developed SIH, of which 55 patients were included in further analysis. Mean fasting and daytime BG levels were 7.8 ± 2.9 mmol/l and 10.9 ± 2.2 mmol/l, respectively. 41/55 patients (74.5%) had elevated average BG levels. 45/55 patients (81.8%) had > 5 readings or > 20% of all readings exceeding hyperglycaemia threshold, and 33/55 patients (60.0%) had pronouncedly elevated BG levels on more than one occasion. 6/55 patients (10.9%) experienced more than one hypoglycaemic event or a severe hypoglycaemia. Only 9/55 patients (16.4%) achieved adequate SIH control according to all defined criteria. Pre-existing diabetes and longer duration of hospital treatment with low glucocorticoid dose were significantly associated with poorer glycaemic control ( p < 0.001 and p = 0.003, respectively). Conclusions Appropriate SIH management was demonstrated to be challenging. According to the defined criteria, adequate glycaemic control during hospitalisation was not achieved in the large majority of patients with SIH. Supplementary Information The online version contains supplementary material available at 10.1007/s43440-021-00234-2.

show abstract

Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum

Cited by 5 publications

References 35 publications

Is the Altman Rule a proxy for glycemic load?

Is the Altman Rule a proxy for glycemic load?

Hospital hyperglycemia: Status Investigation and Effect of a Real-time Glycemic Alert System

Incidence and control of steroid-induced hyperglycaemia in hospitalised patients at a tertiary care centre for lung diseases

Contact Info

Product

Resources

About