Home From The Editor Glucose control in the hospital “an emerging standard of care?

Glucose control in the hospital “an emerging standard of care?

March 2006

Published in the March 2006 issue of Today’s Hospitalist

A flurry of activity last month promises to create more pressure on hospitalists to improve how they will control the glucose level of hospitalized patients.

First came the news that a study found improvements in mortality and morbidity when researchers tightly controlled the glucose levels of patients in a medical ICU. The data are signifi cant because they echo findings released by the same research team in 2001, which found similar benefits to controlling glucose levels in patients in a surgical ICU.

At about the same time those study results were released, two major players in diabetes care released a new consensus statement calling on U.S. hospitals and physicians to do a better job of glucose control.

The report, which was released by the American Association of Clinical Endocrinologists and the American Diabetes Association, calls on physicians to take a number of steps to achieve that goal. It not only calls for hospitals to identify patients with elevated glucose levels, but to establish multidisciplinary teams to manage diabetes and aggressively control blood glucose, both in the ICU and other units throughout the hospital.

The consensus statement acknowledges that there are real obstacles
to improving glucose control. Physicians’ fear of hypoglycemia is one,
and so is cost.

But as the report “and a growing body of studies “make clear, hyperglycemia in the hospital is a real problem, one that will only worsen as more Americans develop diabetes. It’s only a matter of time before payers and policy-makers take note and begin to demand that U.S. hospitals and physicians do better.

Edward Doyle
Editor and Publisher