NOTE: This module is currently in the process of being updated and recertified, and so does not currently offer CME. A fully updated module eligible for CME is expected to be available November 2023.

Diana Childers, MD, Patricia Juang, MD

Based on the original, Managing Diabetes and Hyperglycemia in the Hospital, by David Wesorick, MD and the module, Managing Diabetes and Hyperglycemia in the Hospital: Focus on the Noncritically Ill Patient, by Diana Childers MD and Pedro Ramos MD

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Summary

Hospitalized patients with diabetes require specific medical management in order to minimize the risk of hyperglycemia. This requires hospitalists to have an understanding of methods for glycemic control in both the critically ill and noncritically ill patient. This module, which focuses on the noncritically ill patient, is part of a 2-part series that will evaluate the current scientific evidence regarding glycemic control and discuss which medications are best for controlling blood glucose levels in the hospital. A thorough discussion of how to determine the appropriate insulin dose and develop an insulin regimen for hospitalized patients is provided, as well as strategies for developing a discharge plan for patients on insulin.

Goal

To provide hospitalists with up-to-date information about managing diabetes and hyperglycemia in the noncritically ill patient.

Target Audience

This activity is designed for hospitalists who manage the treatment of patients with diabetes and hyperglycemia. No prerequisites required.

Learning Objectives

After completing the module, the participant should be able to:

1. Evaluate the current scientific evidence regarding glycemic control in the noncritically ill hospitalized patient, including the optimal glycemic target for these patients.
2. Describe which medications are best for controlling blood glucose levels in the hospital and discuss which medications can pose a risk.
3. Compute an appropriate dose of insulin to manage hyperglycemia in the hospital.
4. Formulate an anticipatory, physiologic insulin regimen for a given hospital patient.
5. Judge the importance of matching nutritional insulin with the actual nutritional intake, and discuss ways of accomplishing this.
6. Arrange a discharge plan for patients on insulin in the hospital and discuss various options that are available.
7. Apply the principle of diabetes management to the perioperative patient

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest

Instructions

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: an unaccredited pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Release date: 1/4/2019

Expiration date: 1/4/2022

Estimated time to complete activity: 2 hours