Management of Severe/Acute Hyperglycemia in Hospitalised Type 2 Diabetes Mellitus Patients
DOI:
https://doi.org/10.12970/2310-9971.2013.01.01.3Keywords:
Acute hyperglycemia, type 2 diabetes mellitus, insulin, sliding scale, basal-bolus.Abstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder comprising 90% of all diabetes worldwide. T2DM is characterized by hyperglycemia resulting from insufficient secretion of insulin by beta cells of pancreas, peripheral insulin resistance and accompanied by impaired regulation of hepatic gluconeogenesis. T2DM can be classified into acute complication and chronic complication. Severe/acute hyperglycemia is an acute complication of T2DM, which commonly seen in diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). DKA and HHS are acute metabolic complications caused by absolute or relative deficiency in endogenous insulin level. The presence of severe/acute hyperglycemia is often associated with increasing hospital stays, worsening of infection, post-discharge disability and death. Hence, insulin therapy is the method that most preferred to treat severe/acute hyperglycemia and controlling glycemic level in hospital setting. The subcutaneous insulin administration is the most frequently used in non-critically ill patients admitted to hospital. Management of severe/acute hyperglycemia involves basal-bolus insulin versus sliding–scale insulin and continuous insulin infusion versus subcutaneous insulin infusion. This review focuses on treatment option savailable in hospitalised T2DM patients with acute hyperglycemia.References
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