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Hyperglycaemia in acute coronary syndromes overview

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These are the paths in the Hyperglycaemia in acute coronary syndromes pathway:

Hyperglycaemia in acute coronary syndromes HAI

About

What is covered

This pathway covers the role of intensive insulin therapy in managing hyperglycaemia within the first 48 hours in adults admitted to hospital for acute coronary syndrome (ACS). Hyperglycaemia is common in people admitted to hospital for ACS and is a powerful predictor of poorer survival and increased risk of complications while in hospital. Hyperglycaemia after an ACS is also associated with an increased risk of developing type 2 diabetes.
This pathway covers:
  • the role of intensive insulin therapy in managing hyperglycaemia within the first 48 hours of admission for ACS in people with diagnosed diabetes and people without known diabetes
  • tests for diabetes, lifestyle advice and ongoing monitoring for people without known diabetes.
A wide range of national guidance is available for the care of people with diabetes in hospital and this is relevant to patients with ACS. For example, guidance from the NHS Institute for Innovation and Improvement recommends that all patients with ACS and known diabetes are referred to the inpatient diabetes team.

Updates

Information for the public

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on the following topic.

Patient-centred care

Patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution for England – all NICE guidance is written to reflect these. Treatment and care should take into account individual needs and preferences. People should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If the person is under 16, their family or carers should also be given information and support to help the child or young person to make decisions about their treatment. Healthcare professionals should follow the Department of Health's advice on consent. If someone does not have capacity to make decisions, healthcare professionals should follow the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards.
For young people moving between paediatric and adult services, care should be planned and managed according to the best practice guidance described in the Department of Health’s Transition: getting it right for young people.
Adult and paediatric healthcare teams should work jointly to provide assessment and services to young people. Diagnosis and management should be reviewed throughout the transition process, and there should be clarity about who is the lead clinician to ensure continuity of care.

Updates to this pathway

10 June 2014 Minor maintenance update.
20 December 2013 Minor maintenance update.
9 July 2013 Minor maintenance update.
8 February 2013 Minor maintenance update.

Short Text

Management of hyperglycaemia in adults with acute coronary syndromes

What is covered

This pathway covers the role of intensive insulin therapy in managing hyperglycaemia within the first 48 hours in adults admitted to hospital for acute coronary syndrome (ACS). Hyperglycaemia is common in people admitted to hospital for ACS and is a powerful predictor of poorer survival and increased risk of complications while in hospital. Hyperglycaemia after an ACS is also associated with an increased risk of developing type 2 diabetes.
This pathway covers:
  • the role of intensive insulin therapy in managing hyperglycaemia within the first 48 hours of admission for ACS in people with diagnosed diabetes and people without known diabetes
  • tests for diabetes, lifestyle advice and ongoing monitoring for people without known diabetes.
A wide range of national guidance is available for the care of people with diabetes in hospital and this is relevant to patients with ACS. For example, guidance from the NHS Institute for Innovation and Improvement recommends that all patients with ACS and known diabetes are referred to the inpatient diabetes team.

Sources

The NICE guidance that was used to create the pathway.
Hyperglycaemia in acute coronary syndromes. NICE clinical guideline 130 (2011)

Quality standards

Quality statements

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

Commissioning

These resources include support for commissioners to plan for costs and savings of guidance implementation and meeting quality standards where they apply.
These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.

Education and learning

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Service improvement and audit

These resources provide help with planning ahead for NICE guidance, understanding where you are now, and conducting improvement initiatives.

Pathway information

Information for the public

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on the following topic.

Patient-centred care

Patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution for England – all NICE guidance is written to reflect these. Treatment and care should take into account individual needs and preferences. People should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If the person is under 16, their family or carers should also be given information and support to help the child or young person to make decisions about their treatment. Healthcare professionals should follow the Department of Health's advice on consent. If someone does not have capacity to make decisions, healthcare professionals should follow the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards.
For young people moving between paediatric and adult services, care should be planned and managed according to the best practice guidance described in the Department of Health’s Transition: getting it right for young people.
Adult and paediatric healthcare teams should work jointly to provide assessment and services to young people. Diagnosis and management should be reviewed throughout the transition process, and there should be clarity about who is the lead clinician to ensure continuity of care.

Updates to this pathway

10 June 2014 Minor maintenance update.
20 December 2013 Minor maintenance update.
9 July 2013 Minor maintenance update.
8 February 2013 Minor maintenance update.

Supporting information

Glossary

A blood glucose level above 11 mmol/litre.
An intravenous infusion of insulin and glucose with or without potassium.

Paths in this pathway

Pathway created: October 2011 Last updated: June 2014

© NICE 2014

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