Managing the blood glucose of hospitalized diabetic patients is challenging. The stress of illness and the multiple procedures experienced by patients can all make glucose levels more labile than usual. In 2008, pharmacy and nursing partnered to provide a new service to manage blood glucose values: Pharmacy dosing. If the attending physician orders “Pharmacy dosing,” pharmacists provide insulin orders based on pre-established protocols. The Certified Diabetic Educator (CDE) and several pharmacists worked closely together to create the protocols and roll out the program.
Although it took several years to catch on, as of 2013 approximately half of the diabetic patients have insulin dosing provided through the pharmacy program. Blood glucose values of patients who received insulin dosing by pharmacy are comparable to those receiving insulin dosing by physicians and other providers.
As the program evolves, additions to the protocols have been written which address glucocorticoid induced hyperglycemia and post bariatric surgery dosing. Pharmacy has met the challenges of these more complex patient populations, continuing to demonstrate good blood glucose control for the patients they manage.