Posted by: admin on: May 23, 2011
The American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA) have published updated guidelines for treating high blood glucose while avoiding low blood glucose in hospitalized patients.
The main objectives of the 2009 AACE/ADA recommendations were to identify reasonable, achievable and safe glycemic targets and to describe the protocols, procedures, and system improvements needed to facilitate their implementation.
For most patients a blood glucose target of 140-180 mg/dL is recommended and appropriate use of insulin is the preferred approach for achieving safe, optimal glucose control.
Hyperglycemia in hospitalized patients is common and associated with increased risk of infection, mortality and increased cost. Although near normalization of glucose in these patients appears to be of no greater benefit than moderate glycemic targets, ignoring hyperglycemia in this population is no longer acceptable.
Both over treatment and under treatment of hyperglycemia in hospitalized patient are patient safety issues. AACE/ADA maintains that the upper limit of 180 mg/dl is safe and justified by data on benefits of glycemic control and the harms of uncontrolled hyperglycemia.
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