Castro MMG, Godínez GSA, Liceaga CMG, Alexanderson RG, Cabrera JR, Carrillo ER, Escobedo PJ, García MJ, Mercadillo PMG, Ortega GC, Peña PCA, Ramos RRA, Tamez PHE, Wacher RN, Vázquez MJL, Villagómez OAJ, Aldrete-Velasco J, Cantú RAT, Álvarez AH, Córdova PVH

Language: Spanish
References: 114
Page: 124-153
PDF size: 956.48 Kb.

ABSTRACT

Background: Hyperglycemia is frequently encountered during hospitalization and is associated with adverse outcomes such as acute myocardial infarction, cerebrovascular disease, infection and nephropathy. Is therefore desirable to develop an updated guidelines in order to guide the inpatient glycemic management.
Method: Seventeen physicians and a chemistry with expertise in diabetes and insulin management were invited to participate in the development of the guideline based on criteria such as experience, knowledge and clinical judgment. For the purposes of this review the recommendations were based on clinical evidence levels and the limits used were clinical trials and consensus statements developed in adult population that at some time during their hospital stay showed hyperglycemia.
Results: The expert participants discussed the topics included in this guideline according to their evidence and recommendations levels. Eventually, all the decisions taken were unified in a final document.
Conclusions: A glucose range of 140 to 180 mg/dL is recommended. For noncritically ill patients more stringent targets may be appropriate and a scheduled subcutaneous administration of insulin with basal and correctional components is the preferred strategy. Intravenous insulin infusion is the preferred method for maintaining glycemic control in critically ill patients.

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