dc.contributor.author |
McDonald-Brown, M |
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dc.contributor.author |
Daly, Barbara |
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dc.contributor.author |
Dixon, Robyn |
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dc.coverage.spatial |
Rotorua |
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dc.date.accessioned |
2018-10-09T01:31:22Z |
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dc.date.accessioned |
2018-12-16T04:07:34Z |
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dc.date.issued |
2016-05-05 |
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dc.identifier.uri |
http://hdl.handle.net/2292/45014 |
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dc.description.abstract |
The detection and management of steroid-induced hyperglycaemia and barriers to its effective Management Miranda McDonald-Brown1, Robyn Dixon2 Barbara Daly3, 1Tauranga Hospital, Bay of Plenty District Health Board, Tauranga Hospital, 2Faculty of Medical and Health Science, The University of Auckland BACKGROUND • Glucocorticoids (steroids) are the leading cause of treatment-induced hyperglycaemia.1 • Steroid-induced hyperglycaemia in hospital setting is relatively common,1 however there is a lack of data on its prevalence and management in New Zealand. • Steroids are associated with new-onset hyperglycaemia in approximately a third of patients without diabetes.2 • International guidelines suggest all patients undergoing steroid therapy in hospital should undergo glycaemic monitoring.3,4,5,6 AIMS • To audit and document the rates of glycaemic monitoring for patients administered steroids, and the incidence and management of steroid-induced hyperglycaemia in a hospital setting. • To survey and identify doctors’ and nurses’ self-reported barriers to its detection and management. METHODS • An audit of patients on three general medical wards in a mid-sized NZ hospital, to identify patients administered steroids, on six randomly selected days over a six-week period between June and July, 2015. • A self-administered questionnaire administered to doctors and nurses working on the three medical wards during the study period. RESULTS • Of the 397 patients audited, steroids were administered to 64 (16%) patients, including 38 (59%) patients administered high dose steroids (≥ 40mg prednisone or equivalent). • Only 11 (17%) patients administered steroids had their blood glucose levels (BGLs) monitored. • All patients with type 2 diabetes (n=8) administered steroids were monitored compared with only 5% of patients (n=3) without diagnosed diabetes (p<0.001). • Six (55%) patients had elevated BGLs. Data on hyperglycaemic management of patients administered steroids was limited due to the low number of patients who underwent BGL monitoring. • For the survey, a combined response rate of 63% was achieved, 71% for doctors (n=15) and 60% for nurses (n=45), The most common barriers for detecting and managing steroid-induced hyperglycaemia were the lack of clinical guidelines and insufficient knowledge of insulins. • All 15 doctors (100%) and 37 nurses (82%) reported the provision of a guideline would improve the detection and management of steroid-induced hyperglycaemia. RECOMMENDATIONS • All patients administered steroids should undergo BGL monitoring regardless of their diabetes status. Clinical guideline development and improved knowledge of insulins to treat steroid-induced hyperglycaemia may improve its detection and management. |
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dc.relation.ispartof |
New Zealand Society for the Study of Diabetes Annual Scientific Meeting |
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dc.relation.replaces |
http://hdl.handle.net/2292/39709 |
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dc.relation.replaces |
2292/39709 |
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dc.relation.replaces |
2292/38363 |
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dc.relation.replaces |
http://hdl.handle.net/2292/38363 |
en |
dc.relation.replaces |
2292/38363 |
en |
dc.relation.replaces |
http://hdl.handle.net/2292/38363 |
en |
dc.relation.replaces |
2292/38363 |
en |
dc.relation.replaces |
http://hdl.handle.net/2292/38363 |
en |
dc.relation.replaces |
2292/38363 |
en |
dc.relation.replaces |
http://hdl.handle.net/2292/38363 |
en |
dc.relation.replaces |
2292/38363 |
en |
dc.relation.replaces |
http://hdl.handle.net/2292/38363 |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
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dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
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dc.title |
The detection and management of steroid-induced hyperglycaemia in hospital and barriers to its effective management |
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dc.type |
Conference Poster |
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dc.rights.holder |
Copyright: The authors |
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pubs.author-url |
https://www.ivvy.com/event/NZSD16/page/display/id/18 |
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pubs.merge-from |
2292/38363 |
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pubs.merge-from |
http://hdl.handle.net/2292/38363 |
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dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
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pubs.elements-id |
545592 |
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pubs.org-id |
Medical and Health Sciences |
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pubs.org-id |
Nursing |
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pubs.record-created-at-source-date |
2017-07-28 |
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