Coordinating Hospital Meal Delivery with Insulin Dosing Equals Better Outcomes for Diabetes Patients
<0> AACEAmy Johnson, 904-373-7878 </0>
In some instances, a simple solution may be the best solution to a vexing problem. Improving communication between hospital nursing staff and food service employees results in significantly better blood sugar control for hospitalized patients with diabetes, according to research presented at the .
Shwetha Mallikarjuna, M.D., an endocrinology fellow at the Southern Illinois University (SIU) School of Medicine, and Michael Jakoby, M.D., M.A., Chief of Endocrinology, studied the coordination and timing of meal delivery and insulin dosage at St. John’s Hospital in Springfield, IL over a four month period. The trial compared patients with diabetes on two Internal Medicine floors. On the intervention floor, dietary services personnel passed cards to unit clerks identifying patients with diabetes who had received a food tray. Unit clerks then notified appropriate nurses of food delivery to ensure the timeliness of insulin dosage. On the control floor, food trays were delivered without notification to hospital staff.
According to Dr. Mallikarjuna, administering a rapid acting insulin dose outside of a 15 to 20 minute window before or after a meal creates the potential for inconsistencies between peak insulin activity and carbohydrate absorption, which can lead to significant and undesirable swings in blood sugars after meals. Potential complications of poor blood sugar control include increased risk of infection, delayed wound healing, and prolonged hospital stays.
“Systematic review of hospital food delivery and mealtime insulin dosing practices is an important first step to identify factors that may limit appropriate coordination of patient meals and mealtime insulin,” Dr. Mallikarjuna said. “Close cooperation between physicians with appropriate experience and interest, hospital nursing leadership, and hospital nutrition service personnel is required to devise institution specific procedures to closely link food and dosing of insulin,” she added.