Milan, 17 Mar. (Adnkronos Salute) – “More and more people suffering from diabetes or high blood sugar are hospitalized in Italian hospitals, in surgical departments, as well as in those of medicine or specialists. But it is not always possible to consult a diabetologist to set up an adequate diagnostic-therapeutic procedure. Yet properly managing diabetes, or stress hyperglycemia or other, is essential to ensure the patient the best outcome of treatment and a short stay “.This is underlined by the Italian Society of Internal Medicine (Simi), which for this reason has set up a task force of experts from various scientific societies to draw up ad hoc guidelines: “A real vademecum for the management of diabetes or ‘non-diabetes’ hyperglycemia during hospitalization, even by non-specialists in the field”. The indications are published on the portal of the National System Guidelines of the Higher Institute of Health, informs Simi.
There are about 4 million Italians living with diabetes – recall the internists in a note – and, among these, one in 6 is hospitalized at least once a year. This means that the hospitalization rate of these people is more than double that of the general population (235 per thousand people, against 99 per thousand) and their stay in hospital is on average 1.5 days longer. But the phenomenon can also be observed from another perspective: 20-25% of hospitalized for other diseases are affected by diabetes and the presence of this condition has a significant impact on outcomes (in the case of Covid for example, 30.3% of the deceased had diabetes).However, Simi points out, not all high blood sugar levels found during hospitalization are attributable to diabetes.
“Among all these hyperglycemia – highlights Giorgio Sesti, president of Simi – there are in fact people with ‘known’ diabetes, cases of diabetes ‘of first diagnosis’ (diagnosed for the first time on admission), but also ‘hyperglycemia related to hospitalization or stress’, which often disappear with discharge. Adequate expertise is therefore needed to lead to a correct diagnosis and treatment of these conditions during hospitalization, organizing patient care, once discharged”. Most hospitalizations of people with diabetes or hyperglycemia, however, take place outside of Diabetologie. Hence “the need” noted by Simi “to ground an ad hoc guideline for the ‘Management of diabetes or hyperglycemia in adult patients admitted to a non-critical clinical setting’, that is, outside of intensive or sub-intensive care”.
The initiative was “strongly desired and promoted by Simi – reads the note – which carried it out together with the Association of Diabetologists (AMD), the Italian Society of Diabetology (Sid), the Federation of associations of internist hospital managers (Fadoi), the Italian Society of Gerontology and Geriatrics (Sigg) and the National Association of Medical Nurses (Animo).
“These guidelines for doctors, nurses, dietitians, educators working in hospitals and patients – reports Sesti – recommend carefully evaluating in all hospitalized patients, for any pathology, going to look for the possible presence of hyperglycemia at the time of admission, to reduce the risks deriving from its presence; During hospitalization, especially in the event that it is necessary to establish treatment (with insulin or hypoglycemic drugs), it is also recommended to monitor blood glucose with the classic capillary glycemic monitoring or, where possible, through continuous monitoring systems of blood glucose, paying particular attention to any episodes of hypoglycemia “.
“In subjects with hyperglycemia/diabetes hospitalized and not previously treated with insulin, in case of severe glycemic decompensation – concludes President Simi – the guidelines recommend establishing a basal insulin therapy (with slow and ultra-slow analogues of insulin), possibly using ‘pens’, compared to syringes. Where possible, it is also advisable to have the person with hyperglycemia evaluated by personnel with diabetes expertise and, at the time of discharge, adopt a structured follow-up plan, referring the patient to a diabetes center “.
Access to the site is restricted and reserved for healthcare professionals
You have reached the maximum number of visits