BBIT Education / Resources

Diabetes, Obesity & Nutrition SCN

What's the Issue?

The management of diabetes in hospital is complicated!

It is influenced by...

  • the patient's presenting illness, evolving medical status and medication interactions
  • changes to the patients' routine, such as dietary status and level of activity
  • issues involving the healthcare team and the clinical environment, such as poor coordination of blood glucose testing, administration of insulin and timing of meals
  • the health care providers responsiveness to changes in the patient's glycemic status with appropriate adjustments in medication
  • competing priorities - clinical, environmental and administrative

Currently, when patients present with complex disease and poorly controlled diabetes, the typical response by most care teams is to use a subcutaneous "sliding scale insulin" (SSI) regimen, hoping that this will address the patient's changing:

  • medical status
  • irregular diet
  • routine
  • schedule

However, SSI therapy alone results in costly, and most importantly, unsafe, blood glucose control for the patient.

Clinical evidence supports the use of BBIT as a safer and more clinically versatile alternative. In spite of this evidence, the use of SSI in hospital has persisted, leading to the question of how do we change?

Summary & Guidelines

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