Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline.
OBJECTIVE
The aim was to formulate practice guidelines on the management of hyperglycemia in hospitalized patients in the non-critical care setting.


METHODS
The Task Force was composed of a chair, selected by the Clinical Guidelines Subcommittee of The Endocrine Society, six additional experts, and a methodologist.


METHODS
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence.


METHODS
One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society members, American Diabetes Association, American Heart Association, American Association of Diabetes Educators, European Society of Endocrinology, and the Society of Hospital Medicine reviewed and commented on preliminary drafts of this guideline.


CONCLUSIONS
Hyperglycemia is a common, serious, and costly health care problem in hospitalized patients. Observational and randomized controlled studies indicate that improvement in glycemic control results in lower rates of hospital complications in general medicine and surgery patients. Implementing a standardized sc insulin order set promoting the use of scheduled basal and nutritional insulin therapy is a key intervention in the inpatient management of diabetes. We provide recommendations for practical, achievable, and safe glycemic targets and describe protocols, procedures, and system improvements required to facilitate the achievement of glycemic goals in patients with hyperglycemia and diabetes admitted in non-critical care settings.
Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Guillermo E
GE
Umpierrez
Richard
R
Hellman
Mary T
MT
Korytkowski
Mikhail
M
Kosiborod
Gregory A
GA
Maynard
Victor M
VM
Montori
Jane J
JJ
Seley
Greet
G
Van den Berghe
D015190:Blood Glucose Self-Monitoring / Q000379:methods; D003266:Continuity of Patient Care; D003422:Critical Care; D004704:Endocrinology / Q000331:legislation & jurisprudence / Q000379:methods / Q000458:organization & administration / Q000592:standards; D055317:Evidence-Based Practice / Q000379:methods / Q000639:trends; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007430:Intraoperative Care / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods; D012955:Societies, Medical / Q000331:legislation & jurisprudence
D007004:Hypoglycemic Agents; D007328:Insulin