Patients With Endocrine Disorders: Nine Things to Know
Patients With Endocrine Disorders: Nine Things to Know
Part of the reason this is important is the numbers of patients with the disease who will be hospitalized and come under the care of a hospitalist.
"They're coming in for a host of medical conditions, not the least of which is that diabetes is a comorbid factor that goes along with it," says John Anderson, MD, the ADA's immediate past president of medicine and science and an internist and diabetician at The Frist Clinic in Nashville, Tenn. "For those who are critically ill—those having bypass, those having stroke—diabetes is overrepresented even more once they get inside the hospital and in the intensive care unit."
Job No. 1, controlling blood sugar, can have broad implications, he says.
"We know that control of their glucose through the hospital stay actually makes a difference in long-term outcomes, particularly things like surgery, coronary bypass grafting, that type of thing," he says, noting that the standard of care is to try to keep glucose under 200. "A lot of studies have been done that demonstrate that really poor control of glucose in the hospital, regardless of the disease entity they're in with, can lead to worsening long-term outcomes. It's really imperative that you control the blood sugar.
"However, the other part of this is…that if you control it so tightly that these patients are dropping their blood sugar and having significant hypoglycemia problems in the hospital, that's not good either."
1. Realize the Far-reaching Impact of Good Care for Diabetic Patients
Part of the reason this is important is the numbers of patients with the disease who will be hospitalized and come under the care of a hospitalist.
"They're coming in for a host of medical conditions, not the least of which is that diabetes is a comorbid factor that goes along with it," says John Anderson, MD, the ADA's immediate past president of medicine and science and an internist and diabetician at The Frist Clinic in Nashville, Tenn. "For those who are critically ill—those having bypass, those having stroke—diabetes is overrepresented even more once they get inside the hospital and in the intensive care unit."
Job No. 1, controlling blood sugar, can have broad implications, he says.
"We know that control of their glucose through the hospital stay actually makes a difference in long-term outcomes, particularly things like surgery, coronary bypass grafting, that type of thing," he says, noting that the standard of care is to try to keep glucose under 200. "A lot of studies have been done that demonstrate that really poor control of glucose in the hospital, regardless of the disease entity they're in with, can lead to worsening long-term outcomes. It's really imperative that you control the blood sugar.
"However, the other part of this is…that if you control it so tightly that these patients are dropping their blood sugar and having significant hypoglycemia problems in the hospital, that's not good either."
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