Key Treatment

Diabetic care is best individualized for children, pregnant women, elderly patients, and hospitalized and seriously ill patients (ADA, 2009).

Children with type 1 diabetes are prone to hypoglycemia, which can cause apprehensive stress and result in maladjustment to diabetic treatment. Clinicians need to consider options as diverse as intensive insulin pump therapy to deferring tight glycemic goals until the child attains the maturity to participate in care (SOR: C). In women with preconception diabetes, to lessen the risk of diabetic embryopathy, glycemic goals are to tighten HbA1c within 1% of normal. Planning pregnancy appropriately motivates patients, and the goal can be attained with frequent glucose monitoring (Goldman et al., 1986; Kitzmiller et al., 1991) (SOR: B). In patients older than 65, glycemic control has not been shown to reduce the risk of micro- and macroangiopathy. Clinical judgment suggests that geriatric patients with short-term life expectancy (<10 years) should be treated to a relaxed HbA1c range of about 7.5% to 8.5%, which provides some reserve in preventing acute hyperglycemia and delaying dehydration associated with acute illness, while limiting the risk of hypoglycemia (Brown et al., 2003) (SOR: B). In critically ill surgical patients, glucose level generally should be kept below 140 mg/dL to ensure better outcomes (Furnary et al., 2003; van den Berghe, 2001) (SOR: A).

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

Get My Free Ebook


Post a comment