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Final Scholarly Project: Evidence-Based Practice Guidelines For The Perioperative Management Of Blood Glucose Levels In The Cardiac Surgery Patient, Chelsey Benner

Doctor of Nursing Practice Scholarly Projects

Cardiovascular disease is the leading cause of mortality worldwide, necessitating a high demand for cardiac surgery. A unique stressor for cardiac surgery is an increased surgical stress response involving hyperglycemia. Perioperative hyperglycemia contributes to adverse postoperative outcomes following cardiac surgery. Current evidence examines blood glucose control and its effect on adverse postoperative outcomes, including sternal wound infections, acute kidney injury, prolonged mechanical ventilation, and an increased length of stay in the intensive care unit. Despite the link between hyperglycemia and poor postoperative outcomes, most facilities lack standardized guidelines for the perioperative management of blood glucose levels in cardiac surgery patients. …

Hyperglycemia As A Risk Factor For In-Hospital Mortality In Myocardial Infarction, Ciro Barrantes-Alarcon, Rosalia Fernández-Coronado, Adriel Olortegui-Yzu

Revista de la Facultad de Medicina Humana

Introduction: Myocardial infarction continues with high mortality rates, from 4.6% to 13.1%. There are predictive risk stratification models, such as the Grace Score, which does not include glycemia as a variable. Patients hospitalized for myocardial infarction with hyperglycemia on admission may have higher mortality, in ST elevated and non-elevated infarcts. Objectives: The objective of this review is to identify and systematize the evidence on hyperglycemia on admission as a biomarker of mortality and heart failure in acute myocardial infarction. Materials and Methods: The search was carried out in the MEDLINE database including the MeSH terms hyperglycemia and hospital mortality or …

Community Healthcare Workers (Chw) High-Risk Stabilization Study: Does The Ability Of Chws At Mobile Covid Clinics To Link Patients With Uncontrolled Diabetes To A Physician Improve Short Term Outcomes?, Mo Hadaya, Venkateswar Venkataraman, Jaimy D. Jabon, Kenneth W. Stagliano, Richard T. Jermyn

Rowan-Virtua Research Day

Uncontrolled diabetes may cause preventable but significant effects. One major preventative measure is early screening; there are hopes that community healthcare workers can increase awareness and screening availability, especially in underserved populations. We hosted and recorded logs of patients at mobile COVID health clinics, educating those with uncontrolled diabetes and connecting them to healthcare. We then looked to see if any patients had improvements in blood glucose to non-diabetic levels. 378 patients were logged, but only 138 were in events that had a significant amount of repeat visits. Twenty-five of them had blood sugar indicative of uncontrolled diabetes. Out of …

Purine And Pyrimidine Monophosphate Vs Polyphosphate Homeostasis In Human Retinal Endothelial Cells, Andrew Gregory, Jenna Hart, Thangal Yumnamcha, Mohamed Shawky, Shaimaa El Tanani, Ahmed Ibrahim

Medical Student Research Symposium

Introduction: A major cause of blindness is proliferative diabetic retinopathy (PDR), and there is limited data on the nucleic acid (NA) profiles in PDR. We characterized the profiles of NAs in human retinal endothelial cells (HRECs) subjected to high glucose (HG) and hypoxia (Hyp) - common risk factors associated with PDR.

Methods: HRECs were treated with osmotic control (Mannitol, 25 mM) or high glucose (HG, 25 mM) for 5 days, followed by normoxia or hypoxia (Hyp, 2% O2) for 24 hours. Pathway enrichment analysis from the significant metabolites in the Hyp+HG vs control comparison was subsequently performed.

Results: The precursors …

Role Of Stimulation Intensity On Neuromuscular Electrical Stimulation Induced Changes In Energy Expenditure And Respiratory Quotient, Ulices Villalobos, Jehu N. Apaflo, Gabriel Narvaez, Joshua Labadah, Irene John Tomy, Sudip Bajpeyi

International Journal of Exercise Science: Conference Proceedings

Neuromuscular Electrical Stimulation (NMES) is an alternative technique to stimulate muscle contraction for people who are unmotivated or experiencing physical impairments that prevent them from performing exercise. Previous studies have shown that the use of NMES-induced muscle contraction can increase energy expenditure (EE) and glucose utilization. However, it is unclear if the intensity of the NMES plays a role in the change in EE and glucose utilization. PURPOSE: To determine the effect of NMES intensity on NMES-induced changes in energy expenditure (EE) and whole-body substrate utilization. METHODS: Thirty-six sedentary overweight /obese men (n=15) and women (n=21) participated in …

Thirty Minutes Of Electrical Muscle Stimulation Improves Glycemic Control, Jehu N. Apaflo, Irene John Tomy, Gabriel Narvaez, Joshua Labadah, Ulices Villalobos, Sudip Bajpeyi

International Journal of Exercise Science: Conference Proceedings

Electrical muscle stimulation is a suitable skeletal muscle contraction modality for people with physical functional disabilities and other sedentary individuals. While the extensive use of this technique has focused primarily on muscle strengthening and regeneration during rehabilitation, there is an increasing research interest to explore its potential to improve other metabolic health parameters similar to the benefits of conventional exercise. PURPOSE: This study aims to determine the effect of acute electrical stimulation on glycemic control in a predominantly Hispanic population. METHODS: Thirty-one participants (Males: 10; Females: 21; BMI: 33.3 ± 7.1 kg/m²; Age: 35.1 ± 12.0 …

An Orally Available Compound Suppresses Glucagon Hypersecretion And Normalizes Hyperglycemia In Type 1 Diabetes, Farzad Asadi, Subhadra C. Gunawardana, Roland E. Dolle, David W. Piston

2020-Current year OA Pubs

Suppression of glucagon hypersecretion can normalize hyperglycemia during type 1 diabetes (T1D). Activating erythropoietin-producing human hepatocellular receptor type-A4 (EphA4) on α cells reduced glucagon hypersecretion from dispersed α cells and T1D islets from both human donor and mouse models. We synthesized a high-affinity small molecule agonist for the EphA4 receptor, WCDD301, which showed robust plasma and liver microsome metabolic stability in both mouse and human preparations. In islets and dispersed islet cells from nondiabetic and T1D human donors, WCDD301 reduced glucagon secretion comparable to the natural EphA4 ligand, Ephrin-A5. In diabetic NOD and streptozotocin-treated mice, once-daily oral administration of WCDD301 …

Utilization And Predictors Of Adjuvant Metformin For Children And Adolescents On Mixed Receptor Antagonists (Second-Generation Antipsychotics), Hua Chen, Ning Lyu, Wenyaw Chan, Austin De La Cruz, Chadi Calarge

Journal Articles

OBJECTIVE: to examine utilization and predictors of adjuvant metformin among pediatric recipients of second-generation antipsychotics (SGAs) (mixed receptor antagonist).

METHOD: This study used 2016-2021 data of a national electronic medical record database. Eligible participants were children aged 6 to 17 with a new SGA prescription for at least 90 days. Predictors of prescribing adjuvant metformin in general and to nonobese pediatric SGA recipients in particular were assessed using conditional logistic regression and logistic regression analyses, respectively.

RESULTS: Of 30,009 pediatric SGA recipients identified, 2.3% (n = 785) received adjuvant metformin. Among 597 participants with a body mass index z score …

Diabetes-Associated Hyperglycemia Causes Rapid-Onset Ocular Surface Damage, Judy Weng, Christopher Ross, Jacob Baker, Saleh Alfuraih, Kiumars Shamloo, Ajay Sharma

Pharmacy Faculty Articles and Research

Purpose: The metabolic alterations due to chronic hyperglycemia are well-known to cause diabetes-associated complications. Short-term hyperglycemia has also been shown to cause many acute changes, including hemodynamic alterations and osmotic, oxidative, and inflammatory stress. The present study was designed to investigate whether diabetes-associated hyperglycemia can cause rapid-onset detrimental effects on the tear film, goblet cells, and glycocalyx and can lead to activation of an inflammatory cascade or cellular stress response in the cornea.

Methods: Mouse models of type 1 and type 2 diabetes were used. Tear film volume, goblet cell number, and corneal glycocalyx area were measured on …

An Intraoperative Telemedicine Program To Improve Perioperative Quality Measures: The Actfast-3 Randomized Clinical Trial, Christopher R King, Stephen Gregory, Bradley A Fritz, Thaddeus P Budelier, Arbi Ben Abdallah, Alex Kronzer, Daniel L Helsten, Brian Torres, Sherry Mckinnon, Shreya Goswami, Divya Mehta, Omokhaye Higo, Paul Kerby, Bernadette Henrichs, Mary C Politi, Joanna Abraham, Michael S Avidan, Thomas Kannampallil, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Telemedicine for clinical decision support has been adopted in many health care settings, but its utility in improving intraoperative care has not been assessed.

OBJECTIVE: To pilot the implementation of a real-time intraoperative telemedicine decision support program and evaluate whether it reduces postoperative hypothermia and hyperglycemia as well as other quality of care measures.

DESIGN, SETTING, AND PARTICIPANTS: This single-center pilot randomized clinical trial (Anesthesiology Control Tower-Feedback Alerts to Supplement Treatments [ACTFAST-3]) was conducted from April 3, 2017, to June 30, 2019, at a large academic medical center in the US. A total of 26 254 adult surgical patients …

New Onset, Refractory Hyperglycemia With Diabetic Ketoacidosis After Enfortumab Vedotin Treatment: A Case Report, Ross E. Heinrich, Marie Caldwell

Journal of Maine Medical Center

Introduction: A patient with no prior diagnosis of diabetes presented with diabetic ketoacidosis (DKA) and severe insulin resistance after being treated with enfortumab vedotin (EV). EV-associated DKA is uncommon—described in only a few case reports—and has unknown pathophysiology. This case characterizes the unique features of DKA in this patient and an unusual amount of insulin resistance not typically seen in patients with diabetes.

Clinical Findings: A 71-year-old male presented with fatigue, xerostomia, and increased thirst. He had a history of obesity, hypertension, and invasive, high-grade papillary urothelial carcinoma. His laboratory results were consistent with DKA.

Clinical Course: The patient was …

Impact Of Diabetes Mellitus On Vestibular Function: A Scoping Review, Ellen M. Jones

Dissertations, 2020-current

Diabetes mellitus (DM) encompasses a group of metabolic diseases that result in high blood sugar (i.e., hyperglycemia). By 2030, it is anticipated that 578 million adults worldwide will have DM, with this number growing at a faster rate in developed areas of the world.^[27] If left uncontrolled, DM can cause considerable damage to several areas of the body, including the heart, kidneys, nerves, and ears. When focusing exclusively on the ears, there has been markedly less research on the vestibular system when compared to the auditory system, even though DM is a known risk factor for falling. The purpose …

A Model Study To Evaluate Osseointegration And Fracture Healing Following Open Reduction And Internal Fixation (Orif) In Diabetic Lewis Rats, Alexandra Arteaga, Claudia Biguetti, Bhuvana Lakkasetter Chandrashekar, Jimena Mora, Adeena Qureshi, Evelin Rios, Javier La Fontaine, Danieli C. Rodrigues

School of Podiatric Medicine Publications and Presentations

There is a higher risk of implant osseointegration failure after open reduction and internal fixation (ORIF) in patients with diabetes due to increased inflammatory conditions, associated metallic corrosion and infection. While it is possible to avoid elective osseous surgery in patients with diabetes, it may not be the case in nonelective cases, such as ORIF ankle fractures. A total of 30 male Lewis rats (12-15 weeks old) were distributed into diabetic (D) and nondiabetic (ND) groups. Fracture healing and osseointegration were evaluated at 2-, 10-, and 21-day time points. Microtomographic and histological analysis depicted distinct differences in fracture healing …

Katp Channels Are Necessary For Glucose-Dependent Increases In Amyloid-Β And Alzheimer's Disease-Related Pathology, John Grizzanti, William R. Moritz, Molly Stanley, Emily E. Caesar, Maria S. Remedi, Celeste M. Karch, Colin G. Nichols, David M. Holtzman, Et Al.

2020-Current year OA Pubs

Elevated blood glucose levels, or hyperglycemia, can increase brain excitability and amyloid-β (Aβ) release, offering a mechanistic link between type 2 diabetes and Alzheimer's disease (AD). Since the cellular mechanisms governing this relationship are poorly understood, we explored whether ATP-sensitive potassium (KATP) channels, which couple changes in energy availability with cellular excitability, play a role in AD pathogenesis. First, we demonstrate that KATP channel subunits Kir6.2/KCNJ11 and SUR1/ABCC8 were expressed on excitatory and inhibitory neurons in the human brain, and cortical expression of KCNJ11 and ABCC8 changed with AD pathology in humans and mice. Next, we explored whether eliminating neuronal …

Phytochemical Screening, Antihyperglycemic, Antihyperlipidemic, And Antioxidant Activities Of Parts Of Cleome Rutidosperma: A Comparative Study, Israel Oghenevwodokohwo Okoro, Ifeanyi Famous Ossamulu, Edith Omozefe Okoro

The Thai Journal of Pharmaceutical Sciences

Background/Aim: Cleome rutidosperma is traditionally used as a remedy for several diseases such as diabetes and malarial. The phytochemical screening and influence of hydroethanol extracts of C. rutidosperma parts (leaves and roots) on hyperglycemia, hyperlipidemia, and parameters of oxidative stress in streptozotocin (STZ)-induced diabetes in male albino rats were investigated. Materials and Methods: Qualitative phytochemical assays for the extracts were done by standard procedures. Different doses (75, 150, and 300 mg/kg body weight) of the extracts were administered to STZ-induced diabetic rats. Results: The presence of Alkaloids, Flavonoids, Saponins, Tannins, steroids, Terpenoid, Cardiac glycoside, and Phenol was detected in the …

Effects Of Diabetes On Speech And Language Across The Lifespan, Tayla Slay

2023 SLP Posters

According to the CDC, “diabetes is a chronic health condition that affects the way your body turns food into energy”. More than 37 million adults in the United States have diabetes which is the seventh leading cause of death in the United States. With diabetes affecting such a large portion of the population, what do speech-language pathologists need to know about how blood sugar affects speech and language in various types of individuals? This literature review explores the effects of language development later in the life of babies born to mothers with diabetes. The effects that diabetes has on adults’ …

Examining The Effects Of Hyperglycemia On Retinal Regeneration, Emmanuella Ec Kyllians

Theses and Dissertations--Biology

Diabetes is a disease that affects how the body processes glucose, leading to a cascade of other complications, one of which is diabetic retinopathy (DR). DR is a neurovascular disease that affects the retina and research has revealed the role of retinal neurodegeneration in its development. Animal models like zebrafish have emerged as important tools for studying the molecular and cellular mechanisms underlying DR. On the other hand, retinitis pigmentosa (RP) is a degenerative disease that involves the progressive degeneration of rods and cones, and hyperglycemia has been found to impair regeneration. Therefore, this study aims to examine the effects …

The Role Of Herbal Medicines In Central American Indigenous Communities; Improving Accessibility To Type 2 Diabetes Mellitus Treatment, Sarai Ortega

CMC Senior Theses

Indigenous communities in Central America have used various plant medications to treat illnesses and diseases for centuries. Clinicians must consider improving traditional healthcare methods that are intrinsic to indigenous communities in order to increase access to effective treatments, particularly for diseases that these communities are more at risk for. This work aims to propose a method to identify whether traditional preparations of five plants (Anacardium occidentale L., Hamelia patens Jacq., Momordica charantia L, Neurolaena lobota L. R. Br. Ex Cass., and Tecoma stans L. juss. ex Kunth) can reduce blood glucose levels in rats with type two diabetes. Additionally, …

Elevated Liver Glycogenolysis Mediates Higher Blood Glucose During Acute Exercise In Barth Syndrome, George G. Schweitzer, Grace L. Ditzenberger, Curtis C. Hughey, Brian N. Finck, Michael R. Martino, Christina A. Pacak, Barry J. Byrne, William Todd Cade

2020-Current year OA Pubs

UNLABELLED: Barth syndrome (BTHS) is an X-linked recessive genetic disorder due to mutations in the Tafazzin (TAFAZZIN) gene that lead to cardiac and skeletal muscle mitochondrial dysfunction. Previous studies in humans with BTHS demonstrate that the defects in muscle mitochondrial oxidative metabolism result in an enhanced reliance on anaerobic metabolism during exercise to meet energy demands of muscular work. During exercise, the liver normally increases glucose production via glycogenolysis and gluconeogenesis to match the elevated rate of muscle glucose uptake and meet the ATP requirements of working muscle. However, the impact of Tafazzin deficiency on hepatic glucose production and the …

Establishment Of An In Vivo Streptozotocin-Induced Type 1 Diabetes Model Recapitulating Early Brain And Retinal Fibrosis, Kia Bourdot, Lucy Dawson, Igor Kuzin, Arturo Bravo Nuevo, Zeus Antonello

Cooper Rowan Medical Journal

INTRODUCTION: Diabetes has risen to one of the top American public health concerns. The hyperglycemic state of chronic diabetes leads to microvascular and macrovascular changes that predispose patients to delayed wound healing and organ fibrosis. The validation of models to specifically detect early, quantifiable fibrotic changes seen in the diabetic state is of fundamental importance for understanding the diabetic pathophysiology and exploring earlier management options. Here, we investigated if we could detect early signs of internal fibrosis in a streptozotocin (STZ) diabetic mouse model by quantifying α-SMA expression in various organs using flow cytometry.

METHODS: We used a low-dose STZ-induced …

Differential Role Of Type 2 Diabetes As A Risk Factor For Tuberculosis In The Elderly Versus Younger Adults, Blanca I. Restrepo, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana P. Quirino-Cerrillo, Raúl Loera-Salazar, America Cruz-González, Jose A. Caso, Mateo Joya-Ayala, Esperanza M. García-Oropesa, Alejandra B. Salinas

School of Medicine Publications and Presentations

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age …

Coronavirus Disease 2019 And Diabetes Mellitus, Ashraf M. A. Eid, Ehab K. El Melegy, El-Saied A. Shahin, Khaled S. A. Elkelany, Mariam A. Fouad

Journal of Medicine in Scientific Research

Introduction In late 2019, a new virus severe acute respiratory syndrome coronavirus-2, which causes a new serious disease called coronavirus disease 2019 (COVID-19), spread quickly all over the world. Many complications of diabetes mellitus (DM) such as microvascular and macrovascular complications increase the risk for COVID-19-related severity and mortality. Objective To assess the effect of DM on outcome and severity of COVID-19. Patients and methods This work was a retrospective observation that included confirmed COVID-19-infected patients (PCR positive for COVID-19) who were admitted to Shebin El-Kom Teaching Hospital, Menoufia, Egypt, from March 2021 to March 2022. Laboratory investigations such as …

Impact Of High Glucose On Ocular Surface Glycocalyx Components: Implications For Diabetes-Associated Ocular Surface Damage, Judy Weng, Steven Trinh, Rachel Lee, Rana Metwale, Ajay Sharma

Pharmacy Faculty Articles and Research

Diabetes mellitus causes several detrimental effects on the ocular surface, including compromised barrier function and an increased risk of infections. The glycocalyx plays a vital role in barrier function. The present study was designed to test the effect of a high glucose level on components of glycocalyx. Stratified human corneal and conjunctival epithelial cells were exposed to a high glucose concentration for 24 and 72 h. Changes in Mucin (MUC) 1, 4, 16 expression were quantified using real-time PCR and ELISA. Rose bengal and jacalin staining were used to assess the spatial distribution of MUC16 and O-glycosylation. Changes in the …

Hyperglycemia-Induced Osmotic Demyelination Syndrome In A Type 2 Diabetic With Stable Serum Sodium, Jesse Galuk, Ian Kuckelman, Ankoor Biswas

Aurora GME

No abstract provided.

Diabetic Ketoacidosis In Pediatric Patients, Jarrod Genther

Nursing Student Class Projects (Formerly MSN)

Diabetic Ketoacidosis in Pediatric Patients

Jarrod Genther

Otterbein University

NURS 6810- Advanced Pathophysiology

Deana Batross, DNP & Shivani Bhatnagar, DNP

July 29, 2022

Diabetic Ketoacidosis in Pediatric Patients

Abstract

Diabetic ketoacidosis is a life-threatening complication in children with type 1 diabetes. Children with type 1 diabetes cannot produce endogenous insulin and must receive exogenous insulin to allow glucose influx into cells throughout the body for energy consumption. Without insulin, the child will progress to diabetic ketoacidosis. The covid-19 pandemic introduced new obstacles for patients with a predisposition for type 1 diabetes, presenting with a more profound acidosis, greater need for …

Utilizing A Personal Health Coach In The Management Of T2dm, Emily Killebrew, Matthew Huelsman, Verah Bonareri, Terri Furfaro

Doctor of Nursing Practice Projects

Management of type 2 diabetes mellitus (T2DM) can reduce hemoglobin a1c values and ultimately reduce the risk of morbidity and mortality. Many adults live with uncontrolled T2DM due to a lack of knowledge of disease management. The purpose of this project was to evaluate the implementation of a personal health coach for the management of T2DM in adult patients. An extensive literature review was conducted, and the use of the Diabetes Management Self-Efficacy Scale (DMSES) was chosen to evaluate participants’ self-efficacy regarding their T2DM. Adult patients aged 21-75 with a diagnosis of T2DM and a hemoglobin a1c >7 in a …

Rap1a Activity Elevated The Impact Of Endogenous Ages In Diabetic Collagen To Stimulate Increased Myofibroblast Transition And Oxidative Stress, Stephanie D. Burr, Christopher C. Dorroh, James A. Stewart

Faculty and Student Publications

Diabetics have an increased risk for heart failure due to cardiac fibroblast functional changes occurring as a result of AGE/RAGE signaling. Advanced glycation end products (AGEs) levels are higher in diabetics and stimulate elevated RAGE (receptor for AGE) signaling. AGE/RAGE signaling can alter the expression of proteins linked to extracellular matrix (ECM) remodeling and oxidative stressors. Our lab has identified a small GTPase, Rap1a, that may overlap the AGE/RAGE signaling pathway. We sought to determine the role Rap1a plays in mediating AGE/RAGE changes and to assess the impact of isolated collagen on further altering these changes. Primary cardiac fibroblasts from …

Silencing Alanine Transaminase 2 In Diabetic Liver Attenuates Hyperglycemia By Reducing Gluconeogenesis From Amino Acids, Michael R. Martino, Manuel Gutiérrez-Aguilar, Nicole K. H. Yiew, Andrew J. Lutkewitte, Jason M. Singer, Kyle S. Mccommis, Daniel Ferguson, Kim H. H. Liss, Jun Yoshino, M. Katie Renkemeyer, Gordon I. Smith, Kevin Cho, Justin A. Fletcher, Samuel Klein, Gary J. Patti, Shawn C. Burgess, Brian N. Finck

2020-Current year OA Pubs

Hepatic gluconeogenesis from amino acids contributes significantly to diabetic hyperglycemia, but the molecular mechanisms involved are incompletely understood. Alanine transaminases (ALT1 and ALT2) catalyze the interconversion of alanine and pyruvate, which is required for gluconeogenesis from alanine. We find that ALT2 is overexpressed in the liver of diet-induced obese and db/db mice and that the expression of the gene encoding ALT2 (GPT2) is downregulated following bariatric surgery in people with obesity. The increased hepatic expression of Gpt2 in db/db liver is mediated by activating transcription factor 4, an endoplasmic reticulum stress-activated transcription factor. Hepatocyte-specific knockout of Gpt2 attenuates incorporation of

Tuberculoso Orchiepididymitus In Insulinodependent Type 2 Diabetes Mellitus: Case Report, Gonzalo Carrillo-Sanabria, Brayan Dávila-Aranda, Rodolfo Cairo-Huaringa, Richard Maita-Hinostroza, Jorge Chumbes-Pérez

Revista de la Facultad de Medicina Humana

Introduction: There is little information in Peru on the association of tuberculous orchiepididymitis in relation to immunosuppressed patients, being an endemic country of tuberculosis and there is an increase in the prevalence of chronic noncommunicable diseases such as diabetes, producing wrong diagnoses. Clinical Case: We present the case of a 70-year-old man with a history of type 2 diabetes mellitus who was admitted to the outpatient clinic due to dysuria and frequency. On physical examination, a hard, non-painful right testicle, the ultrasound showed signs of epididymal abscess in the scrotal wall of the Right testicle, which is why an infected …

Basal-Plus Insulin Regimen: Helping Patients With Diabetes Mellitus Type 2 To Maintain Blood Glucose Levels During Hospitalization, Marcia Watts Hammons

Cohort X

Diabetes mellitus type 2 (DM2) patients are at risk of episodes of fluctuating blood glucose levels when in the hospital. On admission at the target practice site, the home dose of oral hypoglycemic medication is typically stopped and replaced with sliding-scale insulin therapy. Hyperglycemia among the hospital population of DM2 patients is common, causing delayed healing times, increased length of stay, increased costs, and other medical detrimental factors. A doctor of nursing practice project was based on the findings from a randomized controlled trial of a basal-plus insulin protocol that lowered the mean blood glucose level for noncritically ill hospitalized …