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 and 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
- About Basal Bolus Insulin Therapy (BBIT)
- BBIT: Implementing BBIT
- BBIT: Titration & Transition
- BBIT: Treating Hypoglycemia
- Key Messages
- Ordering - Paper
- Ordering - SCM
- How to BBIT (For Prescribers)
- BBIT Self-Study Guide for Nursing
- Prescriber Pocket Card
- Nursing Pocket Card
- DM Summary for Nursing
- BBIT Pamphlet
- BBIT FAQ
- BBIT Surgical Considerations