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Hospital Intensive Insulin Program (HIIP)

The Hospital Intensive Insulin Program (HIIP) is an inpatient program developed and managed by Dr. Roma Gianchandani, Assistant Professor in the Division of MEND, Department of Internal Medicine.

Dr. Gianchandani, along with a team of doctors and physician assistants have implemented an intensive insulin protocol for the management of diabetic/hyperglycemic inpatients. The importance of intensive diabetes control in the outpatient setting is now undisputed and there are similar data from several inpatient intensive care settings.

Hyperglycemia in critically ill patients is an important correctable risk factor for inpatient morbidity and mortality. Data supporting the use of an insulin infusion to correct hyperglycemia are available from the cardiothoracic surgery, cardiology and critical care literature.

After major surgical procedures and in critical medical illnesses, patients (both diabetic and nondiabetic) develop hyperglycemia as a result of stress induced insulin resistence. The major cause of hyperglycemia is the release of counterregulatory stress hormones (namely cortisol, growth hormone, catecholamines and glucagon) and local tissue cytokines. Excessive nutritional support, sepsis, hypothermia, hypoxemia, uremia and cirrhosis further reduce insulin production or worsen insulin resistence.

The hospitalized diabetic patient has a 3 - 4 fold higher complication rate due to various metabolic and immunological alterations caused by high blood sugars. Several studies demonstrate an improvement in morbidity and mortality when hyperglycemia is managed with an intensive insulin regimen post cardiothoracic surgery, myocardial infarction and other intensive care settings. Based on this data, several major surgery and bypass programs have adopted intensive insulin management as standard of care with improved clinical outcome.


roma gianchandani  

Roma Gianchandani, M.D., Program Director
Pager: 4634

    Elizabeth Du Bois, Nurse Practitioner
Pager: 16521
Gandia   Kendia Gandia, Physician Assistant
Pager: 16027
Kling-Colson   Sue Kling-Colson, Physician Assistant
Pager: 15674
Zrull   Tina Zrull, Physician Assistant
Pager: 00814
Caplan   Debby Caplan, Nurse Practitioner
Pager: 15993



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