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| | Strengthening In-Patient Hospital Insulin Management Have you or a loved one ever been frustrated by how your diabetes has been managed in a hospital setting? Thanks to a team of clinicians led by Robert Rushakoff, MD and Umesh Masharani, MD, UCSF has tackled this problem head on by putting in place new insulin management systems for patients with diabetes being treated in UCSF hospitals. Through the creation of new insulin management forms, internet training modules, mandatory training courses and conferences/presentations, UCSF is providing physicians, medical and surgical interns and residents, nurses and nurse practitioners, and pharmacists with the support they need to effectively manage in-patient insulin regimens for patients with diabetes. Dr. Rushakoff and third year UCSF Fellow Dr. Melissa Weinberg are in the process of analyzing in-patient diabetes management data to assess the effectiveness of these new systems and to develop new methods of reviewing values that accurately reflects how patients are doing. Both Drs. Rushakoff and Weinberg presented their preliminary data at the American Diabetes Association’s Scientific Sessions held in June 2007 in Chicago. Even though the data hasn’t been fully analyzed, there are indications that the new systems are already making a difference in changing the mindset of clinicians. In recent educational sessions with internal medicine and surgical residents, the questions posed about insulin management were much more sophisticated than a year before, showing an improved understanding of the new diabetes protocols. Not only will all UCSF hospital clinicians be trained, numerous hospitals throughout Northern California are also embracing the UCSF model. In addition, Dr. Rushakoff has been working closely with the Society of Hospital Medicine (SHM) to develop a national resource that educates hospitals on how to create and implement internet-based insulin management training programs. In the future, Dr. Rushakoff and his colleagues will be looking at new ways of managing insulin for hospitalized patients who are not able to ingest food. The goal is to advance from the traditional “sliding scale” insulin delivery protocol that often leads to “rollercoastering” (extreme highs and lows) to a protocol that is focused on titrating injected insulin based on the previous dose of insulin and the current blood glucose level. Also deserving of recognition for their roles in creating these new systems are Mary Sullivan, RN, Melissa Weinberg, MD, Lisa Kroon, PharmD, Tom Bookwalter, PharmD, and Rosanne Rappazini. For more information on these new programs, contact Dr. Rushakoff, Robert.Rushakoff@ucsf.edu . | Related Items |
