Management of hospitalized type 2 diabetes mellitus patients

Abstract

Both hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death. Clinical trials in patients with type 2 diabetes mellitus proved that by improving glycemic control, we can reduce all of them. Insulin is the preferred treatment for glycemic control in most cases, but alternative treatment options that can normalize blood glucose levels without hypoglycemia are being sought. Moreover, hospitalized patients are particularly vulnerable to severe, prolonged hypoglycemia since they may be unable to sense or respond to the early warning signs and symptoms of low blood glucose. Finally, nutritional support, corticosteroid therapy, and surgery increase the risk of hyperglycemia that leads to an increased risk of morbidity and mortality. We review the management of type 2 diabetes mellitus patients who are admitted to the general medical wards of the hospital for a procedure of intercurrent illness.

Median Survival of Clinical Condition Improvement Factors among Patients with Type 2 Diabetes Mellitus in Semarang City, Indonesia

“…The study that is in line with the results of this study is a survival analysis study in Wahidin Sudirohusodo Makassar Hospital, with the conclusion that patients who are not on a diet have a greater risk of failure compared to those on a diet [23]. The recommendations on dietary aspects can contribute to achieve the desired blood glucose, blood pressure, lipid profile and weight [24]. Based on the level of dependency variable, the median survival in patients who perform self-care is 6 days.…”

“…Otherwise stated, type 2 DM patients who on diet of DM need faster time to experience improvement in clinical conditions than those without diet of DM.The study that is in line with the results of this study is a survival analysis study in Wahidin Sudirohusodo Makassar Hospital, with the conclusion that patients who are not on a diet have a greater risk of failure compared to those on a diet[23]. The recommendations on dietary aspects can contribute to achieve the desired blood glucose, blood pressure, lipid profile and weight[24].…”

Modified B-ultrasound method for measurement of antral section only to assess gastric function and guide enteral nutrition in critically ill patients

“…The recovery rates of prealbumin and albumin levels within 7 d after surgery were higher in patients of the modified B-ultrasound method group than in the traditional gastric juice withdrawal group. According to a multicenter survey that involved 26 hospitals in Europe, the nutritional status of patients was significantly negatively correlated with hospital stay, complications and mortality, and patients who received good nutritional support had shorter hospital stay, fewer complications and increased survival rate[ 52 - 55 ]. In the present study, the Kaplan-Meier survival analysis revealed that the complications of patients with good nutritional support were significantly fewer than those in the traditional gastric juice withdrawal group.…”

Epigenetic Control of Endocrine Pancreas Differentiation in vitro: Current Knowledge and Future Perspectives

“…T2DM is a metabolic syndrome characterized by impaired glucose regulation resulting from insulin resistance and progressive loss of β-cells functionality. T2DM pharmacological protocols mainly target the endogenous response to glucose stimulation by increasing insulin sensitivity, insulin secretion, and glucose uptake ( Marín-Peñalver et al, 2016 ). However, the efficacy of such treatments is progressively reduced due to eventual pancreatic β-cells failure ( Kahn, 1994 ; Miller and Nguyen, 2014 ) and exogenous insulin administration is required.…”