Intensive Insulin Therapy in Hospitalized Patients
Authors: Mary Korytkowski, Etie Moghissi, Guillermo Umpierrez
Journal: Annals of Internal Medicine (2011)

Letters21 June 2011Intensive Insulin Therapy in Hospitalized PatientsMary Korytkowski, MD, Etie Moghissi, MD, and Guillermo Umpierrez, MDMary Korytkowski, MDFrom University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; University of California, Los Angeles, Los Angeles, CA 90095; and Emory University School of Medicine, Atlanta, GA 30322.Search for more papers by this author, Etie Moghissi, MDFrom University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; University of California, Los Angeles, Los Angeles, CA 90095; and Emory University School of Medicine, Atlanta, GA 30322.Search for more papers by this author, and Guillermo Umpierrez, MDFrom University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; University of California, Los Angeles, Los Angeles, CA 90095; and Emory University School of Medicine, Atlanta, GA 30322.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-12-201106210-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues' clinical practice guideline (1) on inpatient blood glucose level control recommends against IIT in medical and surgical patients in the hospital. This recommendation is based on a systematic review in which investigators found no consistent evidence to support strict glycemic control, defined as a target blood glucose level of 4.4 to 6.1 mmol/L (80 to 110 mg/dL) (2). The use of IIT to achieve these targets is associated with an increased risk for hypoglycemia, which is related to an increased risk for hospital complications and mortality (3).Qaseem and colleagues' guideline also recommends that ...References1. Qaseem A, Humphrey LL, Chou R, Snow V, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Use of intensive insulin therapy for the management of glycemic control in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;154:260-7. [PMID: 21320941] LinkGoogle Scholar2. Kansagara D, Fu R, Freeman M, Wolf F, Helfand M. Intensive insulin therapy in hospitalized patients: a systematic review. Ann Intern Med. 2011;154:268-82. [PMID: 21320942] LinkGoogle Scholar3. Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009;32:1119-31. [PMID: 19429873] CrossrefMedlineGoogle Scholar4. Umpierrez GE, Smiley D, Jacobs S, Peng L, Temponi A, Mulligan P, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care. 2011;34:256-61. [PMID: 21228246] CrossrefMedlineGoogle Scholar5. Update of ADA's major position statement, “Standards of Medical Care in Diabetes.” Introduction. Diabetes Care. 2011;34 Suppl 1 S1-2. [PMID: 21193624] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pittsburgh School of Medicine, Pittsburgh, PA 15213; University of California, Los Angeles, Los Angeles, CA 90095; and Emory University School of Medicine, Atlanta, GA 30322.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Intensive Insulin Therapy for the Management of Glycemic Control in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Linda L. Humphrey , Roger Chou , Vincenza Snow , Paul Shekelle , and Intensive Insulin Therapy in Hospitalized Patients: A Systematic Review Devan Kansagara , Rongwei Fu , Michele Freeman , Fawn Wolf , and Mark Helfand Intensive Insulin Therapy in Hospitalized Patients Devan Kansagara , Paul Shekelle , and Amir Qaseem Intensive Insulin Therapy in Hospitalized Patients Lynn Bentson Intensive Insulin Therapy in Hospitalized Patients Anthony P. Furnary Intensive Insulin Therapy in Hospitalized Patients Rajesh Garg Metrics Cited ByManagement of Hyperglycemia During the Perioperative Period 21 June 2011Volume 154, Issue 12Page: 846-847KeywordsBloodGlucoseHypoglycemiaInpatientsIntensive care unitsNeutrophilsPatient advocacySystematic reviewsTreatment guidelines ePublished: 21 June 2011 Issue Published: 21 June 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...