OBJECTIVE: Observation of insulin use in consecutive hospitalized diabetic older patients in acute care wards with reference to nutritional intakes, measures of functional status, and varying clinical situations. METHODS: Prospective case study in a geriatric medicine ward with CGA, dietary intake measure and used insulin dosage. RESULTS: Among 600 inpatients, 90 diabetic subjects were found. Only 12.2 % diabetic patients had MMSE > 23 and 23.3% were unable to eat without assistance. During the stay 54 patients had received insulin. From admission to discharge or death, doses were 0.39 to 0.19 U/kg (SD 0.41-0.15) during palliative care, 0.43 to 0.45 U/kg (SD 0.20-0.20) in the event of failure of oral therapy, 0.38 to 0.42 U/kg (SD 0.18-0.25) if creatinine clearance was 30 ml/min or lower, and 0.38 to 0.27 U/kg (SD 0.24-0.26) in critical diseases. Dietary intake increased in all during the stay with an energy intake close to 20 kCal/kg/d at discharge, except for those in palliative care, who had a final intake of 8.2 kCal/kg/d (SD 9.1). CONCLUSION: Insulin treatment guidelines adapted to this frail diabetic population are necessary.
OBJECTIVE: Observation of insulin use in consecutive hospitalized diabetic older patients in acute care wards with reference to nutritional intakes, measures of functional status, and varying clinical situations. METHODS: Prospective case study in a geriatric medicine ward with CGA, dietary intake measure and used insulin dosage. RESULTS: Among 600 inpatients, 90 diabetic subjects were found. Only 12.2 % diabeticpatients had MMSE > 23 and 23.3% were unable to eat without assistance. During the stay 54 patients had received insulin. From admission to discharge or death, doses were 0.39 to 0.19 U/kg (SD 0.41-0.15) during palliative care, 0.43 to 0.45 U/kg (SD 0.20-0.20) in the event of failure of oral therapy, 0.38 to 0.42 U/kg (SD 0.18-0.25) if creatinine clearance was 30 ml/min or lower, and 0.38 to 0.27 U/kg (SD 0.24-0.26) in critical diseases. Dietary intake increased in all during the stay with an energy intake close to 20 kCal/kg/d at discharge, except for those in palliative care, who had a final intake of 8.2 kCal/kg/d (SD 9.1). CONCLUSION:Insulin treatment guidelines adapted to this frail diabetic population are necessary.
Authors: I Bourdel-Marchasson; M Barateau; V Rondeau; L Dequae-Merchadou; N Salles-Montaudon; J P Emeriau; G Manciet; J F Dartigues Journal: Nutrition Date: 2000-01 Impact factor: 4.008
Authors: H Yki-Järvinen; L Ryysy; M Kauppila; E Kujansuu; J Lahti; T Marjanen; L Niskanen; S Rajala; S Salo; P Seppälä; T Tulokas; J Viikari; M R Taskinen Journal: J Clin Endocrinol Metab Date: 1997-12 Impact factor: 5.958
Authors: Louise B Russell; Elmira Valiyeva; Sheila H Roman; Leonard M Pogach; Dong-Churl Suh; Monika M Safford Journal: Diabetes Care Date: 2005-07 Impact factor: 19.112