title: Inpatient hyperglycemia management: A practical review for primary medical and surgical teams.
abstract: Inpatient hyperglycemia is common and is associated with an increased risk of hospital complications, higher healthcare resource utilization, and higher in-hospital mortality rates. Appropriate glycemic control strategies can reduce these risks, although hypoglycemia is a concern. In critically ill patients, intravenous (IV) insulin is most appropriate, with a starting threshold no higher than 180 mg/dL. Once IV insulin is started, the glucose level should be maintained between 140 and 180 mg/dL. In noncritically ill patients, basal-bolus regimens with basal, prandial, and correction components are preferred for those with good nutritional intake. In contrast, a single dose of long-acting insulin plus correction insulin is preferred for patients with poor or no oral intake. Measuring hemoglobin A1c at admission is important to assess glycemic control and to tailor the treatment regimen at discharge.
authors.affiliation: Associate Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.|Director, Inpatient Diabetes Services; Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: M Cecilia
authors.initials: MC
authors.lastname: Lansang
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. E-mail: geumpie@emory.edu.
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D019468:Disease Management; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007297:Inpatients; D061385:Insulins / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic
chemical_list: D007004:Hypoglycemic Agents; D061385:Insulins