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Highlights & Basics
- Inpatient hyperglycemia is not merely a transient response to illness or stress, but a condition that requires active management.
- In both critical and noncritical care settings, glycemic control should be individualized to the patient's clinical status and to the resources available.
- In critically ill patients, the preferred approach is an intravenous insulin infusion accompanied by dextrose infusion. However, tight glycemic control within the normal range of 80-110 mg/dL (4.4 to 6.1 mmol/L) is not generally necessary and may even be harmful.
- For noncritically ill hospitalized patients, a basal-bolus insulin or basal insulin regimen may be used. Sliding scale insulin alone should not be used in these patients, as it is less effective in achieving optimal glycemic control.
- While management principles are similar for medical and surgical patients, hypoglycemia tends to occur more frequently in medical patients and is associated with poorer outcomes. As such, preventing hypoglycemia is a key priority in this population.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
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Pasquel FJ, Lansang MC, Dhatariya K, et al. Management of diabetes and hyperglycaemia in the hospital. Lancet Diabetes Endocrinol. 2021 Mar;9(3):174-88.[Abstract][Full Text]
McCall AL, Lieb DC, Gianchandani R, et al. Management of individuals with diabetes at high risk for hypoglycemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2023 Mar;108(3):529-62.[Abstract][Full Text]
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