Management of inpatient hyperglycemia

Assessing perceptions and barriers to care among resident physicians

Curtiss B. Cook, Dean A. McNaughton, Cathleen M. Braddy, Kimberly A. Jameson, Lori R Roust, Steven A. Smith, Daniel L. Roberts, Stephen L. Thomas, Bryan P. Hull

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: To develop insight into resident physician attitudes about inpatient hyperglycemia and determine perceived barriers to optimal management. Methods: As part of a planned educational program, a questionnaire was designed and administered to determine the opinions of residents about the importance of inpatient glucose control, their perceptions about what glucose ranges were desirable, and the problems they encountered when trying to manage hyperglycemia in hospitalized patients. Results: Of 70 resident physicians from various services, 52 completed the survey (mean age, 31 years; 48% men; 37% in first year of residency training). Most respondents indicated that glucose control was "very important" in critically ill and perioperative patients but only "somewhat important" in non-critically ill patients. Most residents indicated that they would target a therapeutic glucose range within the recommended levels in published guidelines. Most residents also said they felt "somewhat comfortable" managing hyperglycemia and hypoglycemia and using subcutaneous insulin therapy, whereas most residents (48%) were "not at all comfortable" with use of intravenous administration of insulin. In general, respondents were not very familiar with existing institutional policies and preprinted order sets relating to glucose management. The most commonly reported barrier to management of inpatient hyperglycemia was lack of knowledge about appropriate insulin regimens and how to use them. Anxiety about hypoglycemia was only the third most frequent concern. Conclusion: Most residents acknowledged the importance of good glucose control in hospitalized patients and chose target glucose ranges consistent with existing guidelines. Lack of knowledge about insulin treatment options was the most commonly cited barrier to ideal management. Educational programs should emphasize inpatient treatment strategies for glycemic control.

Original languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalEndocrine Practice
Volume13
Issue number2
StatePublished - Mar 2007

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Hyperglycemia
Inpatients
Physicians
Glucose
Insulin
Hypoglycemia
Guidelines
Organizational Policy
Therapeutics
Internship and Residency
Critical Illness
Intravenous Administration
Anxiety
Surveys and Questionnaires

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Cook, C. B., McNaughton, D. A., Braddy, C. M., Jameson, K. A., Roust, L. R., Smith, S. A., ... Hull, B. P. (2007). Management of inpatient hyperglycemia: Assessing perceptions and barriers to care among resident physicians. Endocrine Practice, 13(2), 117-125.

Management of inpatient hyperglycemia : Assessing perceptions and barriers to care among resident physicians. / Cook, Curtiss B.; McNaughton, Dean A.; Braddy, Cathleen M.; Jameson, Kimberly A.; Roust, Lori R; Smith, Steven A.; Roberts, Daniel L.; Thomas, Stephen L.; Hull, Bryan P.

In: Endocrine Practice, Vol. 13, No. 2, 03.2007, p. 117-125.

Research output: Contribution to journalArticle

Cook, CB, McNaughton, DA, Braddy, CM, Jameson, KA, Roust, LR, Smith, SA, Roberts, DL, Thomas, SL & Hull, BP 2007, 'Management of inpatient hyperglycemia: Assessing perceptions and barriers to care among resident physicians', Endocrine Practice, vol. 13, no. 2, pp. 117-125.
Cook CB, McNaughton DA, Braddy CM, Jameson KA, Roust LR, Smith SA et al. Management of inpatient hyperglycemia: Assessing perceptions and barriers to care among resident physicians. Endocrine Practice. 2007 Mar;13(2):117-125.
Cook, Curtiss B. ; McNaughton, Dean A. ; Braddy, Cathleen M. ; Jameson, Kimberly A. ; Roust, Lori R ; Smith, Steven A. ; Roberts, Daniel L. ; Thomas, Stephen L. ; Hull, Bryan P. / Management of inpatient hyperglycemia : Assessing perceptions and barriers to care among resident physicians. In: Endocrine Practice. 2007 ; Vol. 13, No. 2. pp. 117-125.
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