Hospital Hyperglycemia training module 1 for Medical officers

Hospital Hyperglycemia training module 1 for Medical officers by Dr. Om J Lakhani
00:00 🏥 The video discusses the concept of Hospital Hypoglycemia and explains why sliding scale insulin should not be used.
00:13 🚫 Sliding scale insulin is harmful to the patient and it's better not to manage diabetes than to use this method. This method is still used despite numerous advisories against it.
01:38 📈 Hospital hypoglycemia is defined as any random blood sugar above 140.
02:07 ☝️ If a patient's blood sugar is over 140, test for hba1c. If hba1c is over 6.5, the patient had pre-existing diabetes. If hba1c is under 6.5, the hyperglycemia is stress-induced and not diabetes.
03:17 ⏰ Patients in the hospital should be monitored for blood sugars at least four times a day.
03:44 🍲 They need not check post-meal blood sugar each time as the hyperglycemia from the meal would be reflected in the pre-meal blood sugar at the next meal.
05:36 💉 Sliding scale insulin where the insulin dose is increased after the blood sugar goes up results in dual damage. The ideal approach is to prevent the sugar from rising.
12:44 ⚡ Rapid changes in blood sugar leads to reactive oxygen species causing more damage than sustained high glucose.
15:05 🔄 Basel Bolus correction insulin is a more ideal regime than sliding scale insulin. Keep a base level of insulin, and adjust the doses to pre-emptively manage blood sugar spikes.
18:03 📏 Medical practitioners should be equipped with knowledge on proper insulin administration, such as using pens or needles, for effective patient care.
18:32 💊 Insulin syringes come in two colors: red for 40 IU (international unit) per mL, and black and orange for 100 IU per mL. Using the incorrect syringe for a specific insulin could result in disastrous consequences.
21:06 💡 A significant problem faced by practitioners is that 90% of patients already prescribed insulin do not know how to take it
21:37 ❌The needle on top of an insulin pen is meant for single use. Reusing it can lead to problems and it's advised to change the needle every time.
22:17 ⏪ Ideally, insulin pens should be stored in refrigeration they won't work properly if exposed to high temperatures.
23:16 💉 For insulin injections, it's important to maintain proper technique which includes dialing the correct dose, injecting at a 90° angle and regularly changing the injection site. Without these practices, patients can develop lipodystrophies.
24:09 🍭 Sugar pouches should not be used to correct hypoglycemia. Ideally, it should be corrected with glucose.
26:17 ⚠️ Steroids can cause wild fluctuations in blood sugar levels. Practitioners need to be aware of this and should inform the team whenever a new steroid is added or an existing one is changed.

[@kullayappap6355]

Respected Sir Highly thankful for ur very exaustive ,very practical highlighting meticulously covering entire practices and tips in case of Diabetes for every medical person to know and put in practice .U spoke very crystal clear not sparing doctors doing wrong things,who are lack of latest advances . Wish to know more videos from u Sir to keep abreast of medical fraternity . Thank u very much Sir .

[@EndocrinologyIndia]

Wonderful message . Thank you

[@sasi_kumar96]

Great video sir..any book on insulin therapy written by you sir.

[@EndocrinologyIndia]

No but we are coming with an App soon

[@mithidas4295]

In T2D hyperglycemia is associated with hyperinsulinemia due to Insulin Resistance.How can exogenous Insulin lower blood sugar level when endogenous Insulin fails to do so?

[@EndocrinologyIndia]

You are sadly mistaken. Type 2 diabetes is not caused by insulin resistance alone. It is caused by inadequate insulin production required to overcome the insulin resistance. Please see our video on unifying theory in pathogenesis of diabetes to understand more on the same