Management of hyperglycemia in hospitalized patients with renal insufficiency or steroid-induced diabetes.

Abstract:

:Pharmacologic doses of glucocorticoids and chronic renal failure are challenging comorbidities and complications for safe and effective dosing of insulin for the management of hospitalized patients with diabetes. Glucocorticoids are used widely in hospitalized patients and will commonly provoke new-onset hyperglycemia in patients without a prior history of diabetes or will provoke severely uncontrolled hyperglycemia in patients with known diabetes. Insulin therapy is invariably necessary for the treatment of glucocorticoid-induced hyperglycemia and must be tailored to the pharmacodynamics of the glucocorticoid being given. Renal failure causes a decrease in the clearance of insulin, especially exogenous injected insulin. Dosing algorithms for hospitalized patients should be adjusted for patients with renal failure in order to minimize hypoglycemia. Many patients with type 2 diabetes will need little or no therapy after the development of end-stage renal failure. Care must be taken to avoid the overtreatment of hyperglycemia.

journal_name

Curr Diab Rep

journal_title

Current diabetes reports

authors

Baldwin D,Apel J

doi

10.1007/s11892-012-0339-7

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

114-20

issue

1

eissn

1534-4827

issn

1539-0829

journal_volume

13

pub_type

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