Review paper looks at diabetes and stress hyperglycaemia in hospital

Insulin remains the agent of choice for those who are deemed non-critically ill, but who have severe hyperglycaemia, a new review paper has concluded.

The document, published in The Lancet, Diabetes and Endocrinology, also states that continuous insulin infusion remains the therapy of choice during hyperglycaemic crises and critical illness in hospital.

A team of leading experts into the management of inpatient with diabetes included Professor Ketan Dhatariya, who is a Diabetes and Endocrinology Consultant in Norwich.

Together, they wanted to summarise how advances in diabetes technology such as continuous glucose monitoring, automated insulin delivery and remote inpatient diabetes management have been impacting people.

Professor Dhatariya said: “Diabetes and stress hyperglycaemia are common in the hospital setting and are associated with increases in hospital complications, length of stay, and mortality. Furthermore, data from the COVID-19 pandemic have shown how vulnerable people with type 1 and type 2 diabetes are to developing complications in the hospital compared with people without diabetes.

“In this review, we summarised the evidence from observational studies and clinical trials focusing on inpatient care of people with diabetes and stress hyperglycaemia, including the use of insulin and non-insulin treatment strategies, treatment goals, and the application of new technologies in the hospital setting.”

The researchers concluded that although diabetes technology use in hospitals is “rapidly evolving” it is not ready yet for “widespread use”.

Thy wrote: “The experience gained with the use of such technologies in the hospital setting during the COVID-19 pandemic will be invaluable. Research and policy changes that facilitate electronic health record integration of diabetes technologies are urgently needed.

“Healthcare systems should continue to adapt and transform inpatient care of diabetes and hyperglycaemia to provide cost-effective and patient-centred quality care.”

To read the review in full, click here.

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