This month, we look at glycemic control in the hospitalized patient.  While this landmark article evaluates patients in the ICU, how have you integrated the findings of this research into your practice?

• Intensive versus Conventional Glucose Control in Critically Ill Patients

Remember, insulin is a high-alert medication, meaning it’s tied closely to patient safety.  When ordering insulin for inpatient use, remember to:

• Cut back on the patient’s insulin dose to adjust for changes in clinical condition (renal failure, sepsis, diuresis, etc.) and diet (NPO).
• Discontinue mealtime insulin and if the patient will be ordered NPO – and discontinue the insulin order rather than using a communication order.
• Use lispro (instead of regular) administered when the patient starts eating – it is shorter acting than regular insulin and appropriate to administer when the patient is ready to eat (rather than before the meal)