GUIDELINES FOR THE MANAGEMENT OF HYPERGLYCAEMIA IN HOSPITALISED ADULT PATIENTS
Autori:
Ivan Gornik, Dario Rahelić, Ino Husedžinović, Vladimir Gašparović, † Dragutin Ivanović, Željko Krznarić, Ivana Pavlić-Renar
Sažetak
Uvod: cilj je bio ustanoviti smjernice za zbrinjavanje hiperglikemije u odraslih bolesnika hospitaliziranih na odjelima i u jedinicama intenzivne skrbi. Sudionici: Radna skupina koja donosi Smjernice ima dva suvoditelja, a članovi su joj predstavnici stručnih društava Hrvatskog liječničkog zbora. Dokazi: Ove Smjernice su derivirane iz smjernica međunarodnih stručnih društava. Dokazi su evaluirani prema GRADE sustavu (engl. Grading of Recommendations, Assessment, Development and Evaluation) koji uz razinu dokaza opisuje i snagu preporuke. Proces donošenja odluka: Radna skupina je konsenzusom donijela prijedlog Smjernica koji je poslan stručnim društvima HLZ-a na reviziju. Završni oblik smjernica prihvaćaju sva uključena stručna društva.Zaključak: Hiperglikemija je česta, ozbiljna i zahtjevna komplikacija hospitaliziranih bolesnika. Rezultati objavljenih ispitivanja ukazuju na smanjenje morbiditeta i mortaliteta uz kontrolu glikemije. Implementacija standardiziranih protokola koji promoviraju upotrebu bazal-bolus terapiju inzulinom je najvažnija mjera za zbrinjavanje hiperglikemije u bolničkim uvjetima. Ove smjernice su skup racionalnih i provedivih preporuka i prijedloga.
Summary
Introduction: The aim was to prepare guidelines for the management of in-hospital hyperglycaemia in adult patients in intensive care units and regular wards. Contributors: Working group led by two coordinators consists of representatives of professional societies within the Croatian Medical Association. Evidence: These guidelines are derived from the guidelines of international professional societies. Level of evidence and strength of recommendation are evaluated according to GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system. Decision making process: Working group produced Guidelines draft by a consensus. The draft has been delivered to professional societies for review. Final document is accepted by all included societies. Conclusion: Hyperglycaemia is a frequent, serious and demanding complication in hospitalized patients. Results of published studies suggest that its regulation decreases morbidity and mortality. Implementation of locally developed standardized protocols promoting basal-bolus insulin regimen is regarded as the most important measure for management of hyperglycaemia in hospital. Present guidelines are a set of practical, rational and feasible recommendations and suggestions.
