<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1727-897X</journal-id>
<journal-title><![CDATA[MediSur]]></journal-title>
<abbrev-journal-title><![CDATA[Medisur]]></abbrev-journal-title>
<issn>1727-897X</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas, Provincia de Cienfuegos.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1727-897X2019000500622</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Elaboración de una guía para el manejo farmacológico de diabéticos hospitalizados en el Servicio de Medicina Interna]]></article-title>
<article-title xml:lang="en"><![CDATA[Preparation of a guide for hospitalized diabetic pharmacological management in the Internal Medicine Service]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Corona Martínez]]></surname>
<given-names><![CDATA[Luis Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Amador]]></surname>
<given-names><![CDATA[Laydamí]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vélez Pérez]]></surname>
<given-names><![CDATA[Ramón Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Borroto Lecuna]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Abreus]]></surname>
<given-names><![CDATA[Caridad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Universitario Dr. Gustavo Aldereguía Lima  ]]></institution>
<addr-line><![CDATA[Cienfuegos Cienfuegos]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2019</year>
</pub-date>
<volume>17</volume>
<numero>5</numero>
<fpage>622</fpage>
<lpage>632</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1727-897X2019000500622&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1727-897X2019000500622&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1727-897X2019000500622&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento:  La asistencia médica de los diabéticos hospitalizados en salas del Servicio de Medicina Interna del hospital Gustavo Aldereguía Lima, de Cienfuegos, se caracteriza por una gran variabilidad en la actuación, determinada por criterios y enfoques muy personales de los facultativos.  Objetivo:  elaborar una guía para el manejo farmacológico de diabéticos con mal control metabólico o estado de hiperglucemia aguda no complicada, hospitalizados en el Servicio de Medicina Interna.  Métodos:  estudio que incluyó una revisión bibliográfica, a partir de la cual fue elaborada una primera versión de la guía, posteriormente discutida en el colectivo del Servicio de Medicina Interna del Hospital Dr. Gustavo Aldereguía Lima, de Cienfuegos. En las discusiones grupales fueron registradas las críticas y sugerencias a la propuesta. Finalmente, fue elaborado el documento.  Resultados:  entre las acciones más importantes propuestas por la guía, estuvo la estratificación de los pacientes en cuatro grupos diferentes según el grado de control metabólico al ingreso, o por su condición de debut de la enfermedad. Además, se sugirió una conducta terapéutica farmacológica particular para cada uno de esos cuatro grupos. En el caso de los pacientes que ingresan por mal control metabólico o hiperglucemia aguda no complicada, se introdujo el esquema de "insulinoterapia subcutánea programada". Fueron precisados los objetivos metabólicos a alcanzar, y los aspectos diagnósticos y terapéuticos relacionados con la hipoglucemia.  Conclusión:  la Guía para la atención al diabético puede ser de gran utilidad en todos aquellos servicios no críticos (incluyendo los quirúrgicos), donde con muy elevada frecuencia son admitidos estos pacientes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Foundation:  The medical care of diabetics hospitalized in Internal Medicine Service wards of the Gustavo Aldereguía Lima Hospital, Cienfuegos, is characterized by a great variability in the performance, determined by criteria and very personal approaches of the physicians.  Objective:  to develop a guide for the pharmacological management of diabetics with poor metabolic control or a state of uncomplicated acute hyperglycemia, hospitalized in the Internal Medicine Service.  Methods:  a study which included a bibliographic review, from which a first version of the guide was elaborated, later discussed in the staff of the Internal Medicine Service of the Dr. Gustavo Aldereguía Lima Hospital, in Cienfuegos. In the group discussions the criticisms and suggestions to the proposal were registered. Finally, the document was prepared.  Results:  among the most important actions proposed by the guide, was the patient stratification of into four different groups according to the degree of metabolic control at admission, or due to their condition of disease debut. In addition, a particular pharmacological therapeutic behavior was suggested for each of these four groups. In the case of patients admitted due to poor metabolic control or uncomplicated acute hyperglycemia, the "scheduled subcutaneous insulin therapy" scheme was introduced. The metabolic objectives to be achieved were specified, as well as the diagnostic and therapeutic aspects related to hypoglycemia.  Conclusion:  the Guide for diabetic care can be very useful in all non-critical services (including surgical ones), where these patients are very frequently admitted.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Diabetes mellitus]]></kwd>
<kwd lng="es"><![CDATA[hiperglucemia]]></kwd>
<kwd lng="es"><![CDATA[guías como asunto]]></kwd>
<kwd lng="es"><![CDATA[medicina interna]]></kwd>
<kwd lng="en"><![CDATA[Diabetes mellitus]]></kwd>
<kwd lng="en"><![CDATA[hyperglycemia]]></kwd>
<kwd lng="en"><![CDATA[guidelines as topic]]></kwd>
<kwd lng="en"><![CDATA[internal medicine]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roca]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diabetes mellitus]]></article-title>
<source><![CDATA[Temas de Medicina Interna]]></source>
<year>2002</year>
<page-range>211-52</page-range><publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bustillo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedades del Sistema Endocrino. Diabetes mellitus]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Matarama]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[LLanio]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Muñiz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Quintana]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<source><![CDATA[Medicina Interna. Diagnóstico y tratamiento]]></source>
<year>2005</year>
<publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Powers]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diabetes Mellitus]]></article-title>
<source><![CDATA[Harrison. Principios de Medicina Interna]]></source>
<year>2012</year>
<edition>18</edition>
<publisher-loc><![CDATA[New York ]]></publisher-loc>
<publisher-name><![CDATA[McGraw-Hill]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cárdenas]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Villareal]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Lavalle]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de diabetes tipo 2 e hipertensión arterial en adultos de nivel económico bajo de Monterrey, México]]></article-title>
<source><![CDATA[Medicina Universitaria]]></source>
<year>2007</year>
<volume>35</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>64-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wild]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Roglic]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Green]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sicree]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[King]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global prevalence of diabetes estimates for the year 2000 and projections for 2030]]></article-title>
<source><![CDATA[Diabetes Care]]></source>
<year>2004</year>
<volume>5</volume>
<numero>27</numero>
<issue>27</issue>
<page-range>1047-53</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<collab>Centers for Disease Control and Prevention</collab>
<source><![CDATA[National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Georgia ]]></publisher-loc>
<publisher-name><![CDATA[CDC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rydén]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Grant]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Anker]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Ch]]></surname>
<given-names><![CDATA[Berne]]></given-names>
</name>
<name>
<surname><![CDATA[Cosentino]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Danchin]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guía de práctica clínica de la ESC sobre diabetes, prediabetes y enfermedad cardiovascular, en colaboración con la European Association for the Study of Diabetes]]></article-title>
<source><![CDATA[Rev Esp Cardiol.]]></source>
<year>2014</year>
<volume>2</volume>
<numero>67</numero>
<issue>67</issue>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública</collab>
<source><![CDATA[Anuario estadístico de salud 2012]]></source>
<year>2013</year>
<publisher-loc><![CDATA[La Habana ]]></publisher-loc>
<publisher-name><![CDATA[MINSAP]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valdés]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bencosme]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Las complicaciones macrovasculares y su relación con algunas variables clínicas y bioquímicas en diabéticos tipo 2.]]></article-title>
<source><![CDATA[Rev Cubana Endocrinol]]></source>
<year>2010</year>
<volume>3</volume>
<numero>21</numero>
<issue>21</issue>
<page-range>12</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bundó]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Montero]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Cobos]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Aubá]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Arteriopatía periférica de extremidades inferiores y morbimortalidad en pacientes diabéticos tipo 2]]></article-title>
<source><![CDATA[Aten Primaria]]></source>
<year>2006</year>
<volume>3</volume>
<numero>38</numero>
<issue>38</issue>
<page-range>139-46</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Socarrás]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Blanco]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Licea]]></surname>
<given-names><![CDATA[ME.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo de enfermedad aterosclerótica en la diabetes mellitus tipo 2.]]></article-title>
<source><![CDATA[Rev Cubana Med]]></source>
<year>2003</year>
<volume>2</volume>
<numero>42</numero>
<issue>42</issue>
<page-range>7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mahía]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La diabetes mellitus y sus complicaciones vasculares: un problema social de salud]]></article-title>
<source><![CDATA[Rev Cubana Angiol Cir Vasc]]></source>
<year>2000</year>
<volume>1</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tirado]]></surname>
<given-names><![CDATA[OM]]></given-names>
</name>
<name>
<surname><![CDATA[Rivas]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Licea]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Maciquez]]></surname>
<given-names><![CDATA[JE.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo en el desarrollo de la retinopatía diabética]]></article-title>
<source><![CDATA[Rev Cub Oftalmol]]></source>
<year>2011</year>
<volume>1</volume>
<numero>24</numero>
<issue>24</issue>
<page-range>14</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kavanagh]]></surname>
<given-names><![CDATA[BP]]></given-names>
</name>
<name>
<surname><![CDATA[Mc Conen]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Causes and effects of stress hyperglycemia]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2010</year>
<volume>3</volume>
<numero>36</numero>
<issue>36</issue>
<page-range>2540-6</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Corona]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Propuesta de un instrumento para la estratificación en el Departamento de Urgencias del paciente diabético con hiperglucemia aguda no complicada]]></article-title>
<source><![CDATA[Medisur]]></source>
<year>2014</year>
<volume>2</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>10</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Corona]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Resultados de la implementación de un instrumento para la estratificación y manejo del paciente diabético con hiperglucemia aguda no complicada en el Departamento de Urgencias]]></article-title>
<source><![CDATA[Medisur]]></source>
<year>2015</year>
<volume>6</volume>
<numero>13</numero>
<issue>13</issue>
<page-range>16</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<collab>Asociación Americana de Diabetes</collab>
<article-title xml:lang=""><![CDATA[Cuidado de la diabetes en el hospital Estándares de atención médica en Diabetes-2018]]></article-title>
<source><![CDATA[Diabetes Care]]></source>
<year>2018</year>
<volume>41</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>99-104</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ampudia]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of hyperglycemia in the hospital setting a pending question]]></article-title>
<source><![CDATA[Av Diabetol]]></source>
<year>2007</year>
<volume>23</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>74-6</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
