ArticleJournal of diabetes science and technology2013
Clinical inertia during postoperative management of diabetes mellitus: relationship between hyperglycemia and insulin therapy intensification.
Article in Journal of diabetes science and technology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 31 citations in OpenAlex.
- Trial
- Novel Inpatient Automated Self-Adjusting Subcutaneous Insulin Algorithm: 3-Year Experience. An Observational Study.The Journal of clinical endocrinology and metabolism · 2026Observational
- Increasing Frequency of Hemoglobin A1c Measurements in Hospitalized Patients With Diabetes: A Quality Improvement Project Using Lean Six Sigma.Journal of diabetes science and technology · 2024Article
- Novel Automated Self-adjusting Subcutaneous Insulin Algorithm Improves Glycemic Control and Physician Efficiency in Hospitalized Patients.Journal of diabetes science and technology · 2024Article
- Clinical Decision Support for Glycemic Management Reduces Hospital Length of Stay.Diabetes care · 2022Article
- Clinical decision support to improve management of diabetes and dysglycemia in the hospital: a path to optimizing practice and outcomes.BMJ open diabetes research & care · 2021Article
- Overcoming barriers to diabetes care in the hospital: The power of qualitative observations to promote positive change.Journal of evaluation in clinical practice · 2019Article
- Basal-bolus insulin therapy in postoperative inpatients with diabetes mellitus: directions for future quality-improvement initiatives.Future science OA · 2018Article
- Glucometrics and Insulinometrics.Current diabetes reports · 2017Review
- PERSPECTIVES ON LEARNING AND CLINICAL PRACTICE IMPROVEMENT FOR DIABETES IN THE HOSPITAL: A REVIEW OF EDUCATIONAL INTERVENTIONS FOR PROVIDERS.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2017Review
- Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes.Future science OA · 2016Article
- Clinical inertia with regard to intensifying therapy in people with type 2 diabetes treated with basal insulin.Diabetes, obesity & metabolism · 2016Article
- Hyperglycemia during the immediate period following liver transplantation.Future science OA · 2016Article
- Perioperative Management of Patients with Diabetes and Hyperglycemia Undergoing Elective Surgery.Current diabetes reports · 2016Review
- Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes.Cardiovascular diabetology · 2015Observational
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOur objective was to assess the application of insulin regimens in surgical postoperative patients with diabetes.
methodsA chart review was conducted of patients with diabetes who were hospitalized postoperatively between January 1 and April 30, 2011. Analysis was restricted to patients hospitalized for ≥3 days and excluded cases with an endocrinology consult. Insulin regimens were categorized as "basal plus short acting," "short acting only," or "none," and the pattern of use was evaluated by hyperglycemia severity according to tertiles of both mean glucose and the number of glucose measurements >180 mg/dl.
resultsAmong cases selected for analysis (n = 119), examination of changes in insulin use based on tertiles of mean glucose showed that use of basal plus short-acting insulin increased from 10% in the lowest tertile (mean glucose, 120 mg/dl) to 18% in the highest tertile (mean glucose, 198 mg/dl; p < .01); however, 70% of patients in the highest tertile continued to receive short-acting insulin only, with 12% receiving no insulin. Intensification of insulin to a basal plus short-acting regimen was also seen when changes were evaluated by the number of measurements >180 mg/dl (p < .01), but 70% and 12% of patients in the highest tertile still remained only on short-acting insulin or received no insulin, respectively.
conclusionsUse of basal plus short-acting insulin therapy increased with worsening hyperglycemia, but many cases did not have therapy intensified to the recommended insulin regimen--evidence of clinical inertia. Strategies should be devised to overcome inpatient clinical inertia in the treatment of postoperative patients with diabetes.
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