Rodríguez DY, Bustillo SEE, García RMF, Navia RI

Idioma: Español
Referencias bibliográficas: 15
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RESUMEN

Fundamento: el control glucémico del paciente diabético hospitalizado es una prioridad que garantiza resultados positivos de los indicadores hospitalarios. Objetivo: evaluar el uso de los estudios de laboratorio que determinan el control glucémico del paciente diabético hospitalizado. Metodología: se realizó una investigación descriptiva que abarcó dos periodos del año 2009 en el Hospital General Camilo Cienfuegos de Sancti Spíritus. La población del estudio fue de 170 pacientes diabéticos: 157 egresados vivos y 13 fallecidos. Resultados: la utilización de complementarios dirigidos a determinar los niveles de glucemia y la cetonuria al momento del ingreso se indicaron en menos de la mitad de los casos. El seguimiento del la hiperglucemia intrahospitalaria tanto las salas de cuidado convencional y las de cuidados progresivos presentó dificultades. En la mayor parte de los casos no se determinó el grado de control glucémico al egreso. Conclusiones: el diagnóstico y seguimiento de la disglucemia en el paciente diabético hospitalizado en los períodos evaluados no fue óptimo.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, et al.; American Diabetes Association; Diabetes in Hospitals Writing Committee. Management of diabetes and hyperglycemia in hospitals. Diabetes Care 2004;27:553–91. Available from: http://care.diabetesjournals.org/content/27/2/553.long

2. Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al.; Intensive insulin therapy in the critically ill patients. N Engl J Med 2001; 345:1359–67. Available from: http://www.umm.edu/nursing/docs/intensive_insulin_therapy.pdf

3. Malmberg K, Norhammar A, Wedel H, Rydén L. Glycometabolic state at admission: important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: long-term results from the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study. Circulation 1999; 99:2626–32. Available from: http://circ.ahajournals.org/content/99/20/2626.full

4. Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, et al.; NICESUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients. N Engl JMed 2009; 360:1283–97. Available from: http://www.ncbi.nlm.nih.gov/m/pubmed/19318384/

5. Krinsley JS, Grover A. Severe hypoglycemia in critically ill patients: risk factors and outcomes. Crit Care Med 2007;35:2262–7. Available from: http://journals.lww.com/ccmjournal/Abstract/2007/10000/Severe_hypoglycemia_in_critically_i ll_patients_.4.aspx

6. Etie S. Moghissi, Mary T. Korytkowski, Monica DiNardo, Daniel Einhorn, Richard Hellman, Irl B. Hirsch, et al.; American Association of Clinical Endocrinologists; American Diabetes Association. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care 2009;32:1119– 31 Available from: http://care.diabetesjournals.org/content/32/6/1119.short

7. Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA 2008;300:933–944. Available from: http://jama.jamanetwork.com/article.aspx?articleid=182432

8. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians: Implications for Patient Safety and Continuity of Care. JAMA. 2007;297(8):831-41. Available from: http://jama.jamanetwork.com/article.aspx?articleid=205790

9. Standards of Medical Care in Diabetes 2012. Diabetes Care, Volume 35, Supplement 1, January 2012. Available from: http://care.diabetesjournals.org/content/35/Supplement_1/S11.full?sid=32d82637-262a-4f79- b81d-710e86aa3baa

10. Gisela Del Carmen De La Rosa, Jorge Hernando Donado, Alvaro Humberto Restrepo, Alvaro Mauricio Quintero, Luis Gabriel González, Nora Elena Saldarriaga,, et al: Strict glycaemic control in patients hospitalised in a mixed medical and surgical intensive care unit: a randomised clinical trial. Crit Care 2008; 12R120. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2592751/

11. Garber AJ, Moghissi ES, Bransome ED Jr, Clark NG, Clement S, Cobin RH, et al. American College of Endocrinology position statement on inpatient diabetes and metabolic control. Endocr Pract 2004; 10: 77-82. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681039/

12. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE: Hyperglycemia: an independent marker of inhospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 87:978 –982, 2002. Available from: http://jcem.endojournals.org/content/87/3/978.full

13. AACE Diabetes Mellitus Guidelines, Endocr Pract. 2007;13(Suppl 1) 2007. Available from: http://aace.metapress.com/content/a205210114r6l833/fulltext.pdf

14. Cryer PE: Hypoglycemia: the limiting factor in the glycemic management of type I and type II diabetes. Diabetologia 45:937–948, 2002. Available from: http://www.springerlink.com/content/xby30p2fwxt8mjv3/fulltext.html

15. Greci LS, Kailasam M, Malkani S, Katz DL, Hulinsky I, Ahmadi R, et al: Utility of HbA1c levels for diabetes case finding in hospitalized patients with hyperglycemia. Diabetes Care 26:1064–1068, 2003. Available from: http://care.diabetesjournals.org/content/26/4/1064.short