Management of hyperglycemia correction in critical care and Non c ritical care patients

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Lashkar Pravalika

Vaagdevi Pharmacy College, India

: J Clin Exp Dermatol Res

Abstract

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Hyperglycemic is the term for high blood glucose levels. It happens when the body has too little insulin or can’t use insulin properly. In-hospital hyperglycemia is defined as blood glucose (BG) levels >140mg/dl. It is a serious problem if you don’t treat it. It cause a condition called ketoacidosis. Possible adverse outcomes of in- hospital hyperglycemic were high infection rates, increased duration of hospital stay, high mortality rates. American Diabetes Association (ADA) recommended a target glucose between 140 mg/dl (7.8 mmol/l) and 180 mg/dl (10.0 mmol/l) for critically ill patients in the ICU as well as for most patients admitted to general medicine and surgery in the non-ICU setting. Glycemic management of critically ill hospitalized patients includes Management of infection, inflammation, and supportive care is critical , Discontinuation of non-insulin medications & initiation of insulin therapy is recommended for in-hospital management of hyperglycemia in critically ill patients. Benefits include it will decrease mortality, blood infection, acute renal failure, polyneuropathy by 36 to 44%. Several published insulin infusion protocols are safe and effective, with low rates of hypoglycaemia examples- Portland,Leuven, Yale Protocol. Calucation of insulin to control BG in critical ill patients Mix Drip with 40 units Regular Insulin into 39 cc NS then give Bolus initial dose - blood glucose /100, followed by continuous infusion -- blood glucose /100 . Start Rate U / hour = (BG – 60) x 0.02. Monitor BS hrly and adjust the rate of insulin as per various protocol. Based on 24hrs insulin requirement IV insulin is converted into SC dosage . whereas in non ill patients BG are controlled by Basal bolus regimen. ADA Target Glucose levels - non-ICU Patients. Pre-meal glucose targets <140 mg/dL, Random BG <180 mg/dL. Calculation :TDD= 0.4 units/kg/day = 0.4 x 75 = 30U so, Basal insulin dose: 30 x 50/100 = 15 units (Once daily/day) Bolus insulin dose: 30 x 50/100 = 15 units/3 divided doses= 5 units ( Each dose 3times a day).

Biography

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I Lashkar Pravalika completed graduation in Doctor of pharmacy in 2020 from Vaagdevi Pharmacy College, Telangana, India.I worked as a duty doctor in a private hospital. I have published 3 articles and receiving a good responses. Iam currently going for MS in Health informatics. Her open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare.