You Think You Know Inpatient Diabetes Management Jeopardy Template

Inpatients are Different	Target glucose	Insulin Management	Diet	Standing orders and practices
100 What is "Inpatients are Sicker" This is the key difference between most outpatient and inpatient diabetics.	100 What is the target glucose for a well diabetic at home? 70-110 mg/dL	100 What is :"basal insulin" The normal pancreas makes this every moment of every day, sick or well, eating or not.	100 What is "Patients often eat fewer carbs in the hospital?" Home insulin regimens should be evaluated and often changed on admission because of this.	100 What is "Provide a source of glucose for all patients who are NPO?" Hypoglycemic events in Radiology can be prevented by this.
200 What is "The Liver" In a healthy diabetic glucose stores are kept in this organ	200 What is 140-180 mg/dL The target glucose for inpatients	200 What is "nutritional (bolus) insulin?" The normal pancreas responds to a meal but releasing a surge if this.	200 What is "counting carbohydrates eaten"? This task is key to effectively determining the amount of nutritional insulin needed for each meal.	200 What is "Central/PICC line coming out accidentally?" Allowing nurses to start peripheral lines with D10 helps prevent hypoglycemia when the happens.
300 What is "12-16 hours"? Healthy diabetics can store glucose reserves for this many hours.	300 What is "The lowest glucose for which correction insulin is administered?" An easy way to find out a patient's target glucose	300 What is "correction insulin"? The normal pancreas never needs this category of insulin often needed in the hospital.	300 What is "the patient"? This resource is often underused in the management of inpatient diabetes	300 What is "Auto reduction of basal/bolus insulin whenever glucose is < 70 mg/dL"? Standing orders that allow for this help prevent recurrence of hypoglycemic events.
400 What is "Zero"? Diabetics who are sick may have glucose reserves this low.	400 What is "70"? This level represents a blood glucose halfway between target and zero.	400 What is "basal insulin"? EVERY patient in the hospital whose glucose can not be controlled < 180-220 mg/dL at all times should be receiving this.	400 What is "15 minutes before eating to 15 minutes after eating?" Nutritional insulin should be administered during this window related to food intake.	400 What is "Interview the patient to find out at what glucose they feel "low", and what works for them to quickly return their glucose to normal?" Routinely documenting this on admission can breed patient trust and reduce hypoglycemia.
500 What is "Staff?" There glycogen stores are too low so they cannot rescue themselves from their liver, and they do n ot have ready access to high carbohydrate snacks. When sick diabetics get hypoglycemia they are usually rescued only this way	500 What are "infections, longer LOS?" Inpatient glucoses above 220 mg/dL can cause these bad outcomes.	500 What is "sliding scale insulin alone"? This management strategy is outdated by > 20 years and leads to the most common hypo and hyper glycemic events, and should be abandoned!	500 What is "One person does the POCT, one gives the insulin, one delivers the meal?" This division of labor creates challenges in coordinating meals and insulin.	500 What are "Continuous Glucose Monitoring and Insulin Pump Delivery" Modern diabetes management can be done by many patients even better than by hospitals by using these 2 tools.

You Think You Know Inpatient Diabetes Management?

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