Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes
Background. Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective. To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Design. Prospective pre-post-inter...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2015/173956 |
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| author | Giuseppe Marelli Fausto Avanzini Giuseppe Iacuitti Enrico Planca Ilaria Frigerio Giovanna Busi Liliana Carlino Laura Cortesi Maria Carla Roncaglioni Emma Riva |
| author_facet | Giuseppe Marelli Fausto Avanzini Giuseppe Iacuitti Enrico Planca Ilaria Frigerio Giovanna Busi Liliana Carlino Laura Cortesi Maria Carla Roncaglioni Emma Riva |
| author_sort | Giuseppe Marelli |
| collection | DOAJ |
| description | Background. Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective.
To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Design. Prospective pre-post-intervention study.
Methods. In 350 consecutive diabetic in-patients the incidence of hypoglycemia (blood glucose < 70 mg/dL) during subcutaneous insulin treatment was assessed before (phase A) and after (phase B) the protocol was adopted to permit (1) the patient to opt for substitutive food to integrate incomplete carbohydrate intake in the meal; (2) in case of lack of appetite or repeatedly partial intake of the planned food, prandial insulin administered at the end of the meal to be related to the actual amount of carbohydrates eaten; (3) intravenous infusion of glucose during prolonged fasting. Results. Eighty-four patients in phase A and 266 in phase B received subcutaneous insulin for median periods of, respectively, 7 (Q1–Q3 6–12) and 6 days (Q1–Q3 4–9).
Hypoglycemic events declined significantly from 0.34 ± 0.33 per day in phase A to 0.19 ± 0.30 in phase B (P>0.001). Conclusions. A nurse-managed protocol focusing on carbohydrate intake reduced the incidence of hypoglycemia in patients with diabetes receiving subcutaneous insulin in hospital. |
| format | Article |
| id | doaj-art-6f3c969ca30e4691b1711a3f84916eca |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-6f3c969ca30e4691b1711a3f84916eca2025-02-03T01:27:12ZengWileyJournal of Diabetes Research2314-67452314-67532015-01-01201510.1155/2015/173956173956Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with DiabetesGiuseppe Marelli0Fausto Avanzini1Giuseppe Iacuitti2Enrico Planca3Ilaria Frigerio4Giovanna Busi5Liliana Carlino6Laura Cortesi7Maria Carla Roncaglioni8Emma Riva9Diabetes and Metabolic Diseases Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyDivision of Cardiology and Intensive Cardiac Care Unit, Ospedale di Desio, Desio, ItalyIRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156 Milan, ItalyIRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156 Milan, ItalyIRCCS-Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156 Milan, ItalyBackground. Hypoglycemia due to inadequate carbohydrate intake is a frequent complication of insulin treatment of diabetic in-patients. Objective. To assess the effectiveness of a nurse-managed protocol to prevent hypoglycemia during subcutaneous insulin treatment. Design. Prospective pre-post-intervention study. Methods. In 350 consecutive diabetic in-patients the incidence of hypoglycemia (blood glucose < 70 mg/dL) during subcutaneous insulin treatment was assessed before (phase A) and after (phase B) the protocol was adopted to permit (1) the patient to opt for substitutive food to integrate incomplete carbohydrate intake in the meal; (2) in case of lack of appetite or repeatedly partial intake of the planned food, prandial insulin administered at the end of the meal to be related to the actual amount of carbohydrates eaten; (3) intravenous infusion of glucose during prolonged fasting. Results. Eighty-four patients in phase A and 266 in phase B received subcutaneous insulin for median periods of, respectively, 7 (Q1–Q3 6–12) and 6 days (Q1–Q3 4–9). Hypoglycemic events declined significantly from 0.34 ± 0.33 per day in phase A to 0.19 ± 0.30 in phase B (P>0.001). Conclusions. A nurse-managed protocol focusing on carbohydrate intake reduced the incidence of hypoglycemia in patients with diabetes receiving subcutaneous insulin in hospital.http://dx.doi.org/10.1155/2015/173956 |
| spellingShingle | Giuseppe Marelli Fausto Avanzini Giuseppe Iacuitti Enrico Planca Ilaria Frigerio Giovanna Busi Liliana Carlino Laura Cortesi Maria Carla Roncaglioni Emma Riva Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes Journal of Diabetes Research |
| title | Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes |
| title_full | Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes |
| title_fullStr | Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes |
| title_full_unstemmed | Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes |
| title_short | Effectiveness of a Nurse-Managed Protocol to Prevent Hypoglycemia in Hospitalized Patients with Diabetes |
| title_sort | effectiveness of a nurse managed protocol to prevent hypoglycemia in hospitalized patients with diabetes |
| url | http://dx.doi.org/10.1155/2015/173956 |
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