The Hands-On Guide to Diabetes Care in Hospital.

Intro -- Title page -- Copyright -- Preface -- Abbreviations -- PART 1 Basics -- 1 Classification of diabetes -- Phenotypic features of classical Type 1 and Type 2 diabetes -- 2 Targets for glycaemic control in hospital -- Myocardial infarction (Chapters 13 and 14) -- Stroke -- ICU/HDU -- Surgical patients (Chapter 27) -- References -- 3 Diagnosis of diabetes in hospitalised patients -- Stress hyperglycaemia -- 4 Nomenclature -- Capillary blood glucose -- VRIII (Variable Rate Intravenous Insulin Infusion, 'sliding scale' in the UK) -- HbA1c (glycated haemoglobin) -- References -- 5 Outline of physiology -- Insulin actions -- Diabetic ketoacidosis (Chapter 9) -- Insulin resistance -- Renal disease -- Hyperosmolar hyperglycaemic state -- Hypoglycaemia (Chapters 11 and 26) -- Further reading -- 6 Diabetes specialist nurses: roles and responsibilities -- PART 2 Acute diabetes problems -- 7 History taking in patients with diabetes -- Type of diabetes/diagnosis (Chapter 1) -- Duration of diabetes -- Treatment (Chapter 24) -- Complications -- 8 Assessment and initial management of patients presenting with high blood glucose levels to an emergency department -- Type 1 diabetes intercepted early In its course -- Poorly controlled patients with known Type 1 diabetes -- Newly presenting Type 2 diabetes -- Patients attending the ED with high blood glucose levels -- 9 Diabetic ketoacidosis -- Give soluble insulin intravenously at 6 U/hr -- Confirm the diagnosis -- Indicators of severity (Table 9.2) -- Overall management priorities -- ASK THE FOLLOWING after diagnosis, initial assessment and immediate treatment -- Acute management - up to 4 hours -- Management from 4-12 hours -- Check electrolytes at 8 hours -- Management from 12-24 hours -- Planning for discharge -- Further reading -- 10 Hyperosmolar hyperglycaemic state (HHS).

Confirm the diagnosis (Table 10.1) -- Indicators of severity (Table 10.2) -- Management priorities (Table 10.3) -- Correcting serum [Na+] for prevailing glucose -- ask THE FOLLOWING after diagnosis, initial assessment and treatment -- Complete any 'routine' investigations -- Additional history -- Prescriptions -- Continuing management up to 24-48 hours -- Continuing management - usually after 24 hours -- 11 Managing acute hypoglycaemia in the emergency department -- Treatment (see Chapter 26) -- PART 3 Acute medical and surgical problems commonly complicated by diabetes -- 12 Presentation of cardiac disease in diabetic patients -- Features of ACS (Box 12.1) -- Heart failure -- 13 Acute coronary syndromes and stroke -- ACS -- Practicalities of blood glucose control in ACS patients (Figure 13.1) -- Stroke -- 14 Secondary prevention after ACS -- Table of checklist items (Table 14.1) -- 15 Acute pancreatitis -- Hyperglycaemia during and after AP -- Abdominal pain and hyperglycaemia -- Management of diabetes -- 16 Infections in diabetes -- Soft tissue infections -- TREATMENT (Table 16.1) -- Necrotizing fasciitis -- Diabetic foot ulcers -- Admission -- Osteomyelitis (Table 16.2) -- Charcot neuroarthropathy (Figure 16.7) -- Tissue viability team -- The Multidisciplinary foot team -- Urinary tract infections -- Choice of antibiotic -- Abdominal infections -- Musculoskeletal infections -- Chest infections -- Uncommon/rare infections thought to be almost specific to diabetes -- Postoperative infections -- PART 4 Insulin and non-insulin agents -- 17 Variable Rate Intravenous Insulin Infusion (VRIII, 'sliding scale' - UK -- insulin drip - USA) -- Indications for VRIII (Table 17.1) -- 18 Converting from VRIII to subcutaneous insulin -- 19 Writing safe insulin prescriptions -- 20 Insulin preparations in the UK (BNF section 6.1.1) -- Background information.

NOTES ON Individual insulin preparations -- 21 Commonly used insulin regimens -- Basal insulin (Group 1 -- Figure 21.1) -- Basal-bolus regimen (Group 1 + Group 2 -- Figure 21.2) -- Biphasic (fixed-mixture) insulin regimens - Usually Two Times Daily Before Breakfast and Evening Meal, Sometimes Three Times Daily (Group 3 -- Figure 21.3) -- Insulin pump (Continuous Subcutaneous Insulin Infusion, CSII -- Figure 21.4) -- 22 Emergency subcutaneous insulin regimens -- Scenario 1: New basal-bolus insulin (Multiple Dose Insulin, Three Injections of Fast-acting Preprandial Insulin, One Dose of Long-acting Insulin at Bedtime) -- Scenario 2: new twice-daily biphasic insulin (Type 2 patients) -- 23 Substituting insulin preparations in the emergency setting -- Discussion with patients -- Substitution -- 24 Non-insulin agents (BNF sections 6.1.2.1-3) -- Metformin -- Sulphonylureas (SU) -- Other classes of medication -- References -- PART 5 Blood glucose management on the wards -- 25 Managing patients you are asked to see with high blood glucose levels -- The patient with CBG &gt -- 20 mmol/L (see Table 25.1) -- VRIII and 'stat' doses of soluble insulin -- References -- 26 Management of acute hypoglycaemia on the ward -- Mild/asymptomatic/biochemical hypoglycaemia (CBG &lt -- 4.0 mmol/L) -- Oral treatment (Figure 26.1) -- Severe hypoglycaemia (BG &lt -- 3.1 mmol/L) -- Parenteral treatment (Figure 26.2) -- Non-diabetic hypoglycaemia -- Further reading -- 27 Perioperative management of elective surgery -- Patients suitable for day-case surgery -- Poorly-controlled patients -- Admission the night before surgery -- Management of diabetes medication -- Intravenous fluids -- Further reading -- 28 Enteral feeding -- Non-insulin agents, including oral hypoglycaemics (Chapter 24) -- Insulin treatment (Box 28.1) -- Subcutaneous insulin -- Reference -- Further reading.

29 Steroid-induced diabetes -- Management -- Further reading -- 30 Safe discharge of patients from hospital -- Discharge summary -- Sick day rules -- Medication -- Follow-up -- Guidelines and flowchart for patients -- PART 6 Important odds and ends -- 31 Technology in diabetes -- Capillary blood glucose metERs -- Urinalysis -- Insulin delivery devices -- Insulin pumps (Continuous Subcutaneous Insulin Infusion, CSII -- Chapter 21) -- Existing and future technology which you may be asked about -- 32 Inpatient screening schedule -- Focused clinical examination (Figure 32.1) -- 33 Practical procedures -- Capillary blood glucose testing using a hospital-based system (Figure 33.1) -- Capillary blood glucose testing using a typical home device (Figure 33.2) -- Giving a subcutaneous insulin injection (Figure 33.3) -- Practical wound dressing for a diabetic foot ulcer (Figure 33.4) -- Direct ophthalmoscopy (Figure 33.5) -- 34 On-call guide to hyperglycaemic emergencies -- Hyperosmolar Hyperglycaemic State (HHS) - no longer called HONK -- Diabetic ketoacidosis (DKA) -- Index -- EULA.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.