Diabetes Management in Hospitalized Patients - A Comprehensive Clinical Guide (Contemporary Endocrinology) (Jan 19, 2024)_(303144647X)_(Springer)

As the diabetes epidemic continues to burden the healthcare system, and with the literature supporting enhanced patient outcomes with improved glycemic control, the need for expertise in the clinical management of inpatient diabetes is an increasingly important and timely matter. While some books have been published on inpatient diabetes, this guide serves as a comprehensive but clinically relevant review of the available literature and recommended management for the key areas surrounding hospital diabetes management. This book is designed to provide practical guidance on diabetes management for hospitalized patients. The number of topics covered is meant to be comprehensive and include discussion on many potential scenarios encountered on the inpatient service, but in a concise and user-friendly manner. This book is intended to be a valuable resource for fellows, residents, students, and existing providers looking to improve their knowledge and skills in evidence-based inpatient diabetes management. The enclosed chapters were written by many globally renowned physicians, researchers, and clinicians. Diabetes Management in Hospitalized Patients: A Comprehensive Clinical Guide is a valuable resource for endocrinologists, hospitalists, pharmacists, PAs and NPs, and all staff responsible for clinical care of these patients. Foreword Preface Acknowledgment Contents Part I: Basics of Inpatient Diabetes Management Chapter 1: The History of Inpatient Diabetes Introduction Inpatient Diabetes Epidemiology Landmark Inpatient Diabetes Studies ICU Studies (See Table 1.1) Non-ICU Studies (See Table 1.2) Historical Overview of Key Inpatient Guideline Recommendations Endocrine Society American Diabetes Association American Association of Clinical Endocrinology Historical Overview of Inpatient Diabetes Teams Diabetes Technology Conclusion References Chapter 2: Current Standards of Care for Inpatient Type 2 Diabetes Mellitus Introduction Diagnosis of Diabetes Mellitus and Hyperglycemia Methods of Glucose Monitoring Inpatient Glucose Targets Inpatient Pharmacotherapies for Hyperglycemia and T2DM Non-insulin Pharmacotherapies Insulin Initiation Insulin Titration Correctional Dosing of Insulin Discharge Planning Conclusion References Chapter 3: Evaluation and Management of Inpatient Hypoglycemia Introduction Current Definitions Risk Factors False Hypoglycemia: Importance of “Cleaning Data” Hypoglycemia Treatment Protocols Hypoglycemia Prediction Models Continuous Glucose Monitoring in the Inpatient Setting Documentation Prevention Education Glucometrics Future Considerations Conclusion References Chapter 4: Inpatient Type 1 Diabetes Introduction: Global Incidence and Prevalence of Type 1 Diabetes T1DM, Differential Diagnosis, Caring for T1DM in the Hospital Setting Hyperglycemic Crises and T1DM Inpatient Glycemic Targets Wearable Technology: Continuous Subcutaneous Insulin Infusion (CSII) or Insulin Pump Therapy (IPT) and Continuous Glucose Monitoring (CGM) Perioperative Management and T1DM Immunotherapy-Induced T1DM: Checkpoint Inhibitor-Related Autoimmune Diabetes Mellitus (CIADM) Conclusion: On The Horizon—Present and Future Trends; Glucose Telemetry References Chapter 5: Diabetes in the Critically Ill Patient: DKA, HHS, and Beyond Introduction Diabetic Ketoacidosis DKA Pathophysiology DKA Precipitating Factors DKA Clinical Features and Diagnostic Criteria DKA Management Fluid Resuscitation and Restoration of Circulatory Volume Electrolyte Imbalances Insulin Therapy Transitioning from Insulin Infusion to Basal-Bolus Insulin Regimen Hyperosmolar Hyperglycemic State HHS Pathophysiology HHS Precipitating Factors HHS Clinical Features and Diagnostic Criteria HHS Management Fluid Resuscitation and Restoration of Circulatory Volume Electrolyte Management Insulin Therapy and Transition to a Basal-Bolus Regimen Treatment Considerations in Special Populations: CKD and Heart Failure Hyperglycemia in the ICU Conclusion References Chapter 6: Use of Non-insulin Agents for Hyperglycemia Management in Hospitalized Patients Introduction Metformin Sulfonylureas Thiazolidinediones, Meglitinides, Alpha-Glucosidase Inhibitors Dipeptidyl Peptidase-4 Inhibitors Glucagon-Like Peptide-1 Receptor Agonists Sodium Glucose Co-transporter-2 Inhibitors Conclusion References Part II: Diabetes Technology in the Hospital Chapter 7: Clinical Practice Update: Inpatient Insulin Pump and Integrated Insulin Delivery Systems Background DM Prevalence Inpatient Glycemic Management Insulin Pump Therapy and Device-Driven DM Care Evolution in Insulin Pump and CGM Systems Conventional Insulin Pump Therapy Sensor-Augmented Insulin Pump (SAP) Automated Insulin Dosing (AID) Systems Insulin Pump Transitions into the Inpatient Setting Ideal Insulin Pump Candidates in the Inpatient Setting Consensus Guidelines and Updates Clinical Indications Logistical Considerations Behavioral Attributes Approach to Inpatient Management of Insulin Pump Therapy Inpatient Endocrinology or DM Specialist Consultation Adjusted Glucose Targets in the Inpatient Setting Patient Agreement with Inpatient Hospital Policies and Contract Daily Data Review and Documentation Changing Pump Supplies and Refilling the Reservoir Capillary Glucose Measurements and Insulin Dose Adjustments Physical Exam of Patient with Insulin Pump and CGM Cybersecurity and Hospital Policies Considerations to Continue or Discontinue CSII or AID Systems Patient-Related Considerations to Continue or Discontinue CSII or AID Hospital-Related Considerations to Continue or Discontinue CSII or AID Device-Related Considerations to Continue or Discontinue CSII or AID Medication and Nutrition-Related Considerations to Continue or Discontinue CSII or AID Surgical Related Considerations to Continue or Discontinue CSII or AID Transitions Between Insulin Pump and Subcutaneous Regimen (See Fig. 7.2) Transition from Insulin Pump to Subcutaneous Multiple Daily-Injection (MDI) Insulin Regimen Transition from Multiple Daily Injection (MDI) Insulin to Insulin Pump Therapy Conclusion References Chapter 8: Continuous Glucose Monitoring in the Hospital Setting: Current Status and Future Directions Introduction CGM in Noncritical Care Settings CGM in Critical Care Settings Current and Future Considerations for Inpatient CGM Conclusion References Chapter 9: Computer-Guided Approaches to Inpatient Insulin Management Introduction Subcutaneous Insulin Dosing Calculators Intravenous Insulin Dosing Calculators Disease-Specific Studies and Outcomes with IV Calculators Advantages and Disadvantages of Insulin Dosing Calculators Conclusion References Chapter 10: Remote Glucose Management for Hospitalized Patients Introduction Remote Asynchronous Glucose Management Remote Synchronous Glucose Management Automation Conclusion References Part III: Inpatient Diabetes Management in Unique Populations Chapter 11: Diabetes Management in the Emergency Department Emergency Department Approach to Diabetes Mellitus-Related Emergencies Introduction Hypoglycemia Hyperglycemia Evaluation and Management of Hyperglycemic Crisis Management of Hyperglycemia in the Absence of a Hyperglycemic Emergency Type 1 DM (T1D) in the ED Diabetes Management in the Emergency Department Observation Unit (EDOU) Introduction Hemoglobin A1c (HbA1C) Use in the EDOU Hyperglycemia Management in the EDOU Hypoglycemia Management in the EDOU Endocrinology Consult in the EDOU Transition to Outpatient Conclusion References Chapter 12: Inpatient Glucocorticoid-Induced Hyperglycemia Introduction Glucocorticoid-Induced Hyperglycemia Epidemiology Common Indications for Glucocorticoids Morbidity and Mortality of Glucocorticoid-Induced Hyperglycemia Glucocorticoids and COVID-19 Mechanisms of Glucocorticoid-Induced Hyperglycemia Comparison of Commonly Used Glucocorticoids in Inpatient Settings Detection and Monitoring of Glucocorticoid-Induced Hyperglycemia Management of Glucocorticoid-Induced Hyperglycemia Practical Guidance with Glucocorticoid Dose Adjustments and Transition to Outpatient Care Conclusion References Chapter 13: Diabetes and COVID-19 Introduction: Impact of COVID-19 on Diabetes Bidirectional Relationship of COVID-19 and Diabetes COVID-19 and Diabetes Mellitus: Pathophysiology Newly Diagnosed Diabetes in Patients with COVID-19 Healthcare Disparities Case 1 Discussion Case 2 Discussion Continuous Glucose Monitoring Use in the COVID-19 Pandemic Multidisciplinary Approach to Patients with COVID-19 and Diabetes Conclusion References Chapter 14: Overview of Inpatient Management of Hypertriglyceridemia Associated Acute Pancreatitis in Patients with Diabetes Mellitus Introduction Hypertriglyceridemia and Acute Pancreatitis Management of Acute Pancreatitis Secondary to Hypertriglyceridemia Discussion of Diabetes Drugs and Risk for Pancreatitis Conclusion References Chapter 15: Type 3c Diabetes Introduction Epidemiology Pathophysiology Clinical Manifestations Definitions and Diagnosis Management Conclusion References Chapter 16: Cystic Fibrosis-related Diabetes Introduction Pathophysiology of Cystic Fibrosis-related Diabetes Diagnosis of Cystic Fibrosis-related Diabetes Complications and Outcomes of Cystic Fibrosis-related Diabetes Management of CFRD Nutrition and Exercise Considerations Insulin Monitoring Inpatient-Specific Considerations in the Management of CFRD Non-insulin DM Agents Repaglinide GLP-1 Receptor Agonists DPP-IV Inhibitors Metformin Future Directions Conclusion References Chapter 17: Inpatient Management of Diabetes During Pregnancy Introduction Inpatient Glycemic Targets During Pregnancy Management Guidelines for the Hospitalized Pregnant Diabetes Patient General Measures Oral Antidiabetic Agents Insulin Hypoglycemia During Pregnancy Intrapartum (Labor and Delivery) Glycemic Monitoring and Management in Latent Phase of Labor Glycemic Monitoring and Management in Active Phase of Labor Glycemic Monitoring and Management in Special Scenarios C-Section Insulin Pump Continuous Glucose Monitoring Systems Inpatient Management of Patients on Regular Insulin (U-500) Diabetic Ketoacidosis Betamethasone Treatment in Preterm Labor Conclusion References Chapter 18: Postpartum Diabetes Management Introduction Postpartum Physiology Glucose Monitoring Frequency, Mode, and Glycemic Targets Lifestyle Modification Healthy Eating Postpartum Nutrition Considerations Being Active Healthy Coping Lactation Support Benefits of Breastfeeding Contraception During Lactation Medication Prescription in the Postpartum Period Conclusion References Chapter 19: Perioperative Management of Blood Glucose in Adults with Diabetes Mellitus Introduction Pathophysiology of Hyperglycemia and Surgery Preoperative, Intraoperative, and Postoperative Hyperglycemia Glucose Management Goals Based on Current Literature HbA1c Target Glucose Target Preoperative Evaluation Metformin Sulfonylureas and Meglitinides Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Dipeptidyl Peptidase 4 (DPP-4) Inhibitors Thiazolidinediones Alpha-Glucosidase Inhibitors (Acarbose) Insulin Intraoperative Evaluation Postoperative Evaluation Emergency Surgery Management of Type 1 Diabetes in the Perioperative Period Diabetes Technology in the Perioperative Period Continuous Glucose Monitoring System (CGM) Continuous Subcutaneous Insulin Infusion (Insulin Pump) Enhanced Recovery After Surgery (ERAS) Protocol for Patients with Diabetes Conclusion References Chapter 20: Hyperglycemia and Diabetes in the Posttransplant Patient Introduction Terminology Epidemiology Risk Factors Evaluation and Diagnosis of PTDM Inpatient Management of Hyperglycemia Posttransplantation Glucose Targets Intraoperative Management Immediate ( 60 mL/min) CKD Stages 3/4 (eGFR 15–59 mL/min) CKD Stage 5/ESRD (eGFR