Diabetes management in the hospital

Hyperglycemia is an increasingly common and often complex condition to manage in the inpatient setting. Numerous clinical trials have demonstrated associations between uncontrolled diabetes and poor clinical outcomes in a number of inpatient settings. Insulin remains the treatment of choice for the majority of hyperglycemic hospitalized patients and should be prescribed in a physiologic manner, employing basal and bolus insulin. Intravenous insulin should be used liberally in the ICU setting where randomized studies have demonstrated improved outcomes. Recommendations for insulin use in the inpatient setting are provided.     

我院糖尿病专科护士在高级护理实践中的角色探讨

通过对我院糖尿病专科护士角色,功能的介绍,指出国内高级实践护士的发展尚处于起步阶段。在借鉴国外发展经验的同时,思考我国糖尿病专科护士发展前景与对策,以期为我国糖尿病专科护理的发展提供参考依据,培养出适合我国国情的高素质护理人才。     

Diabetes in pregnancy

A number of risk factors exist for pregnant women with diabetes and their babies. Collaborative care can ensure that women with pre-existing diabetes, and those who develop diabetes during pregnancy, receive appropriate and individualised care.     

Weight in Diabetes

Diabetes is being increasingly detected among the overweight. The author discusses the links between diabetes and obesity, and outlines methods by which satisfactory weight reduction may be achieved.     

Diabetes duration and cause-specific mortality in the Verona Diabetes Study

OBJECTIVE: To examine the 10-year mortality and effect of diabetes duration on overall and cause-specific mortality in diabetic subjects in the Verona Diabetes Study (VDS). RESEARCH DESIGN AND METHODS: Records from diabetes clinics, family physicians, and a drug consumption database were used to identify 5,818 subjects > or =45 years of age with type 2 diabetes who were alive and residing in Verona, Italy on 31 December 1986. Vital status of each subject was ascertained on 31 December 1996. Underlying causes of death were determined from death certificates. Death rates and death rate ratios (DRRs) were computed and standardized to the population of Verona in 1991. RESULTS: During the study, 2,328 subjects died; 974 deaths were attributable to cardiovascular disease, 517 to neoplasms, 324 to diabetes-related diseases, 134 to digestive diseases, 250 to other natural causes, and 48 to external causes. There were 81 subjects who died of unknown causes. Death rates from natural causes were higher in men than in women (DRR 1.4, 95% CI 1.2-1.5) and rose in both sexes with increasing duration of diabetes (P = 0.001). Among the natural causes of death, those for diabetes-related diseases were strongly related to diabetes duration (P = 0.001). a modest relationship with duration was also found for ischemic heart disease in men (P = 0.07). CONCLUSIONS: Cardiovascular disease was the principal cause of death among people with type 2 diabetes in the VDS. Rates for natural causes of death rose with increasing duration of diabetes. Deaths from diabetes-related diseases in both sexes and from ischemic heart disease in men were largely responsible for this increase.