Diabetes Mellitus and Hyperglycemia Management in the Hospitalized Patient

Diabetes mellitus and hyperglycemia are common in hospitalized patients. Uncontrolled hyperglycemia during hospitalization is associated with poor outcomes. A glucose goal of 140-180 mg/dL is recommended. Scheduled subcutaneous insulin with basal, prandial, and correction components is preferred for treating diabetes in non-critically ill patients. The pharmacodynamics of insulins differ, and the type of insulin used should match daily glucose excursions. Varying hospital settings may warrant using a particular insulin type to achieve optimal glucose control. Herein we describe approaches to address hyperglycemia in the hospitalized patient on the basis of insulin pharmacodynamic profiles.