• Implementing Carbohydrate-Based Mealtime Insulin Dosing

• The Essentials of Basal Bolus Insulin Therapy

• Managing Acute Hyperglycemia Crises

• The Path to Advanced Inpatient Diabetes Certificate of Distinction

• Controlling Hyperglycemia: Overcoming Inertia

• Implementing Successful Glucose Management in Hospitals

• Refining TGC: New Themes in the Literature & Challenges for Clinicians

Implementing Carbohydrate Based Mealtime Insulin Dosing

Gary Stouder, MD
Board certified family physician from Greenfield, IN with an inpatient and outpatient practice limited to diabetes

Regulating glucose with insulin is essential to proper care for patients with diabetes and hyperglycemia. Whether administered intravenously (IV) or subcutaneously (subQ), basal or maintenance levels of insulin are required to sustain a consistent target glucose range. But for those patients who are eating, bolus dosages are required to avoid the spikes following carbohydrate consumption, and correction dosages are necessary to fine tune the most appropriate glucose levels. Establishing a hospital-wide dietary process that makes it easier for nurses to provide the appropriate basal, mealtime bolus, and correction insulin dosages at the right time for patients who are eating is the focus of this MDNU webinar.

Your presenter, Dr. Gary Stouder, whose practice is limited to diabetic patients, led the design and implementation efforts of mealtime carbohydrate counting at Hancock Regional Hospital in Greenfield, IN. You will learn how to start a mealtime carbohydrate counting program, how to construct and train the team, and you’ll be shown the most effective ways to implement the plan. Dr. Stouder also discusses IV and subQ basal, bolus, and correction insulin dosing based on the dependable carbohydrate data this procedure provides to the caregivers. He shares the results his hospital has achieved, the techniques that worked, and those that did not.

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The Essentials of Basal Bolus Insulin Therapy

Rattan Juneja MBBS, MD, MRCP (UK)
Co-Director, Clarian, Diabetes Centers, Indiana University School of Medicine Chief of Endocrinology, Wishard Memorial Hospital

Considering the enormous worldwide effort on the part of clinicians to control inpatient glucose, this webinar will provide a rare and valuable opportunity to raise your insulin IQ. As the more sophisticated paper and computerized insulin dosing protocols rapidly replace sliding scale dosing, caregivers will need to become proficient with the appropriate indications for the various insulin preparations, AND with the most effective administration of basal, bolus, and correction insulin.

Your presenter is Rattan Juneja, MD, MBBS, MRCP, an Associate Professor of Clinical Medicine, Division of Endocrinology, and Medical Director, Indiana University Diabetes Center. In his clear and entertaining style, Dr. Juneja will discuss the differences between regular, long-acting, and rapid-acting insulin, and how they should be used to both achieve and sustain the hyperglycemic patient’s optimal glucose range. With glucose variability’s effect on patient outcomes the current target of growing attention, the combination of basal, bolus, and correction insulin dosing for patients who are eating is quickly becoming essential knowledge.

This webinar will cover methods that mimic nature with insulin therapy, the basics of insulin algorithms, preventing glucose spikes by scheduling dosages around meals,  transitioning from IV to subcutaneous dosing, the “1500 Rule”, suggested order sets, factors effecting hypoglycemia risk, and core knowledge and competencies for doctors and nurses.

This fact-filled hour will have significant long-lasting and practical value for Nurses, diabetes educators, dietary staff, endocrinologists, pharmacy staff, hospitalists, and anyone in your hospital involved in inpatient glucose care and management.

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Managing Acute Hyperglycemia Crises

Leonard Mastbaum, MD, FACE

Medical Director, Diabetes Treatment Centers, Lutheran and Parkview Hospitals in Fort Wayne, Indiana

Unmanaged inpatient hyperglycemia can lead to a variety of preventable complications, but when hyperglycemia becomes severe enough, it can be fatal. This webinar addresses the precipitating factors, symptoms, and treatment of the most severe forms of hyperglycemia - Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS).

While the incidence of DKA continues to rise, mortality has been decreasing, likely due to proper treatment. HHS on the other hand, while less frequent, is associated with an alarmingly high mortality rate. Recognizing the symptoms and understanding the differences between DKA and HHS are critical to proper treatment.

Our webinar presenter, Leonard Mastbaum, MD, FACE is the Medical Director of the Diabetes Treatment Centers at Lutheran and Parkview Hospitals in Fort Wayne, Indiana.  He is a Clinical Associate Professor at the Indiana University School of Medicine, and serves on the Medical Advisory Committee of Healthways, Inc. Dr. Mastbaum is board certified in Internal Medicine and Diabetes and Metabolic Diseases, and is Fellow of the American College of Endocrinology.  

Who should attend: ICU nurses, Diabetes Educators, Endocrinologists, Intensivists, Hospitalists, Pharmacists, and anyone responsible for inpatient diabetes and hyperglycemia treatment, care, prevention and management.

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Rattan Juneja MBBS, MD, MRCP (UK)
Co-Director, Clarian, Diabetes Centers, Indiana University School of Medicine Chief of Endocrinology, Wishard Memorial Hospital

Even after understanding the benefits of controlling hyperglycemia in the hospital, many health care providers and administrators are overwhelmed by the challenges inherent in change. 

Like steering an oil tanker, changing protocols and practices in a hospital can be a slow, methodical, and often daunting process. But to improve the quality of healthcare, inpatient hyperglycemia must be controlled.

This webinar addresses strategies that simplify the shift toward effective glucose management and overcome the inertia that impedes positive change.

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Joni Carroll, R.N., C.D.E. Indiana University Hospital/Clarian Health.

You know why glucose management is vital to outcomes…

You’ve seen the evidence supporting the need for inpatient glucose management. You’ve heard experts warn of the dangers of both hyper- and hypoglycemia to critically ill patients. You may have volunteered or been chosen for the glucose management team. You and your colleagues are confident that your hospital can improve patient outcomes by reducing patient blood glucose levels. Taking the initiative will benefit your patients, your hospital, and your career. You know it’s the right thing to do.

What to do next…

Protocols have to be selected, processes have to be implemented, and tools have to be purchased. Staff members have to be trained. Results have to be measured. You can’t do it alone. You’ll need to enlist the support of a variety of cross-functional teams in your hospital – nurses, physicians, pharmacists, administrators, dieticians, and laboratorians. This clear and concise MDNU webinar will show you how to tailor your message to their priorities and objectives.

What you say to whom…

Your speaker, Joni Carroll is an RN, Certified Diabetes Educator at Indiana University Clarian Health. A veteran glucose management champion and trainer, Ms. Carroll has assembled one of the largest and most successful glucose management teams in the country. In this one hour webinar, she shares her skillful “what you say to whom” techniques to get the right people on board and committed to successful glucose control in your hospital.

Who should view?

Anyone involved in Glucose Management: Intensivists, Endocrinologists, Nurse Managers, Diabetes Educators, Quality Managers, Glucose management champions and teams.

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James Krinsley, M.D. Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons/ Director of Critical Care at Stamford Hospital

Evidence emphasizing the importance of glucose control in critically ill patients continues to emerge but remains controversial.  Some studies have even reported no benefit. It is now clear that glycemic control can introduce the risk of hypoglycemia, which has been found to be associated with increased mortality.  So, what is optimal control?  

Thought leaders agree that glucose control is important and suggest that the early Tight Glucose Control protocols may need to be reexamined to maximize patient outcomes. New findings also indicate that glycemic variability may be an even more important predictor of mortality in the critically ill than mean glucose level.

This webinar will keep you abreast of the latest research in glucose management. Your presenter, the noted James S. Krinsley, MD, FCCM is widely published in the medical scientific literature and is extensively cited in the field of glycemic control throughout the world. Dr. Krinsley was instrumental in developing a ground-breaking data-driven quality improvement program for his hospital, which has been recognized by the Joint Commission’s distinguished Ernest A. Codman Award.  

Dr. Krinsley’s presentation suggests that a one-size-fits-all tight glucose control protocol may not be the answer for every patient in every hospital’s ICU. Instead, he suggests a new paradigm – Safe, Effective Glycemic Control, or SEGC.

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