Hyperglycemia in Hospitalized Adult Patients
Essential Points
Essential Points
- Continuous glucose monitoring systems can effectively achieve glycemic targets and reduce hypoglycemia in hospitalized patients.
- Patients receiving glucocorticoid therapy or enteral nutrition are at high risk for hyperglycemia and require scheduled insulin therapy in the hospital.
- Patients using insulin pump therapy before hospital admission may self-manage these devices with oversight by hospital personnel.
- Diabetes self-management education to hospitalized patients can promote improved glycemic control with reductions in the risk for hospital readmission.
- Patients with diabetes scheduled for elective surgery may have improved postoperative outcomes when pre-operative hemoglobin A1c (HbA1c) is ≤8% and when blood glucose (BG) values in the immediate pre-operative period are <180 mg/dL.
- Providing pre-operative carbohydrate containing beverages to patients with known diabetes is not recommended.
- Patients with newly recognized hyperglycemia or well-managed diabetes on non-insulin therapy may be treated with correctional insulin alone as initial therapy at hospital admission.
- Scheduled insulin therapy is preferred for patients experiencing persistent blood glucose values >180 mg/dL.
- Dipeptidyl peptidase inhibitors can be used in combination with correction insulin in selected patients with type 2 diabetes who have milder degrees of hyperglycemia provided there are no contraindications to the use of these agents.
Definitions of Terms Used
...tions of Terms Used...
...le insulin (SSI): Reactive approach to insuli...
Treatment
...reatme...
...tly Available Injectable Insulin PreparationsHavin...
...ndation 1.1In adults with insulin-tre...
Table 2. Resources Required for Safe I...
...logy for Converting Insulin Pump Ther...
....1In adult patients who are hospitalized fo...
...mmendation 3.1In adult patients using insuli...
...ecommendation 4.1In adult patients with diabetes...
...commendation 5.1For adult patients w...
...ndation 5.2For adult patients with diabetes under...
...n 6.1In adult patients hospitalized for non-cr...
...endation 7.1In most adult patients...
Recommendation 7.2In select adult pa...
...mendation 8.1In adult patients with type 1 diabete...
....1In adult patients with non-insulin treated T2...
...ecommendation 9.2In adult patients w...
...ations 9.1 and 9.2Remarks: Patients...
...tion 10.1In adults with no prior history of dia...
...tion 10.2In adults with diabetes treated wit...
...10.3In adults with insulin-treated diabetes pri...