Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Setting: An Endocrine Society Clinical Practice Guideline
Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Setting: An Endocrine Society Clinical Practice Guideline
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DOI：
10.1210/jc.2011-2098
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发表时间：
2012-01-01
影响因子：
5.8
通讯作者：
Van den Berghe, Greet
中科院分区：
文献类型：
--
作者：
Umpierrez, Guillermo E.;Hellman, Richard;Van den Berghe, Greet
目的：为非危重重症住院患者高血糖的处理制定实践指南。参与者：工作组由内分泌学会临床指南小组委员会选出的一位主席、另外六位专家和一位方法学家组成。证据：本循证指南采用建议、评估、发展和评价分级（GRADE）系统来描述建议的强度和证据的质量。共识过程：一个小组会议、几个电话会议和电子邮件通信使共识成为可能。内分泌学会成员、美国糖尿病协会、美国心脏协会、美国糖尿病教育者协会、欧洲内分泌学会和医院医学学会对该指南的初步草案进行了审查和评论。结论：高血糖是住院患者常见的、严重的、昂贵的卫生保健问题。观察性和随机对照研究表明，改善血糖控制可降低普通内科和外科患者的医院并发症发生率。实施标准化的sc胰岛素顺序集，促进使用预定的基础和营养胰岛素治疗是糖尿病住院管理的关键干预措施。我们提供实用的、可实现的和安全的血糖目标建议，并描述了在非重症监护环境中入院的高血糖和糖尿病患者实现血糖目标所需的方案、程序和系统改进。[J] .中华内分泌杂志37(5):357 - 357,2012。
Objective: The aim was to formulate practice guidelines on the management of hyperglycemia in hospitalized patients in the non-critical care setting.Participants: The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee of The Endocrine Society, six additional experts, and a methodologist.Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence.Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society members, American Diabetes Association, American Heart Association, American Association of Diabetes Educators, European Society of Endocrinology, and the Society of Hospital Medicine reviewed and commented on preliminary drafts of this guideline.Conclusions: Hyperglycemia is a common, serious, and costly health care problem in hospitalized patients. Observational and randomized controlled studies indicate that improvement in glycemic control results in lower rates of hospital complications in general medicine and surgery patients. Implementing a standardized sc insulin order set promoting the use of scheduled basal and nutritional insulin therapy is a key intervention in the inpatient management of diabetes. We provide recommendations for practical, achievable, and safe glycemic targets and describe protocols, procedures, and system improvements required to facilitate the achievement of glycemic goals in patients with hyperglycemia and diabetes admitted in non-critical care settings. (J Clin Endocrinol Metab 97: 16-38, 2012)