Cda clinical practice guidelines 2013 pdf forward this error screen to sharedip-10718044127. Please forward this error screen to sharedip-1071800229. Basal Bolus Insulin Therapy is an initial priority.
Why is Diabetes in Hospital Important? Diabetes is a very common condition, affecting an estimated 1 in 20 Canadians. Local data suggests that 1 in 5 adult patients admitted to hospital in Alberta has diabetes. It is estimated that the health care budget contributes 13 billion dollars per year to the care of 2 million Canadians with Diabetes. If clinicians fail to recognize and treat hyperglycemia appropriately, diabetic patients are at risk for multi-organ complications, infection, prolonged hospitalization, and increased mortality1, 2. Basal Bolus Insulin therapy allows clinicians to customize insulin regimens based on the unique needs of each patient.
It is proactive, and aims to anticipate the patient’s insulin needs. It prevents blood sugar highs and lows, allowing the patient to feel better. Traditional sliding scale insulin treatment is not individualized, and can result in greater blood sugar fluctuation throughout the day. IMPORTANT: Though BBIT relies on a safe calculation to establish insulin doses, it does not replace clinical judgment. BBIT is a common method of treating diabetes outside of the hospital setting, and therefore may be more familiar to patients. Basal – Long acting insulin to reproduce endogenous insulin that is normally produced by the pancreas 24 hours per day in those without diabetes.
Bolus – Short acting insulin to balance the carbohydrate intake with meals. Insulin Correction – Additional short acting insulin used to make small corrections and bring blood glucose back to target, if needed. Our ultimate objective is to promote safe and effective diabetes management in hospital by focusing on clinical education, quality improvement and knowledge translation. If a recurrent correction dose is needed at a given meal due to a consistently elevated blood glucose, then the correction dose amount should be added to the PREVIOUS meal’s bolus dose! Discuss the situation surrounding the hypoglycemic event with the patient.