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Inpatient Management of Diabetes and Hyperglycemia

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Abstract

Individuals with diabetes mellitus (DM) are more likely to be hospitalized and have longer durations of hospital stay than those without DM (Moghissi et al., Endocr Pract 15(4): 353–369, 2009). Approximately one in four patients admitted to the hospital has a known diagnosis of DM (Umpierrez et al., J Clin Endocrinol Metab 87(3): 978–982, 2002; Jiang et al. Diabetes Care 26(5): 1421–1426, 2003), and about 30% of patients with DM require two or more hospitalizations in any given year (Jiang et al. Diabetes Care 26(5): 1421–1426, 2003). A 2007 study estimated that 22% of all hospital inpatient days were incurred by people with DM and costs associated with hospitalization for DM patients accounted for half of all healthcare expenditures for the disease (American Diabetes Association, Diabetes Care, 31(3): 596–615, 2008). Given the increasing incidence and prevalence of DM in the Unites States since that time (Geiss et al., JAMA 312(12): 1218–1226, 2014), it is likely that these figures have only increased.

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References

  1. Moghissi ES, Korytkowski MT, Dinardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353–69.

    Article  PubMed  Google Scholar 

  2. Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87(3):978–82.

    Article  CAS  PubMed  Google Scholar 

  3. Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003;26(5):1421–6.

    Article  PubMed  Google Scholar 

  4. American Diabetes Association. Economic costs of diabetes in the US in 2007. Diabetes Care. 2008;31(3):596–615.

    Article  Google Scholar 

  5. Geiss LS, Wang J, Cheng YJ, et al. Prevalence and incidence trends for diagnosed diabetes among adult aged 20 to 79 years, United States, 1980-2012. JAMA. 2014;312(12):1218–26.

    Article  CAS  PubMed  Google Scholar 

  6. Levetan CS, Passaro M, Jablonski K, Kass M, Ratner RE. Unrecognized diabetes among hospitalized patients. Diabetes Care. 1998;21(2):246–9.

    Article  CAS  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention. Crude and age-adjusted percentage of civilian, noninstitutionalized population with diagnosed diabetes, United States, 1980–2011. Atlanta, GA: CDC; n.d.. http://www.cdc.gov/diabetes/statistics/us/index.htm. Accessed 6 Dec 2015.

  8. Magaji V, Johnston JM. Inpatient management of hyperglycemia and diabetes. Clin Diab. 2011;29(1):3–9.

    Article  Google Scholar 

  9. Horton WB, Weeks AQ, Rhinewalt JM, et al. Analysis of a guideline-derived resident educational program on inpatient glycemic control. South Med J. 2015;108(10):596–8.

    CAS  PubMed  Google Scholar 

  10. Capes SE, Hunt D, Malmberg K, et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke. 2001;32(10):2426–32.

    Article  CAS  PubMed  Google Scholar 

  11. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000;355(9206):773–8.

    Article  CAS  PubMed  Google Scholar 

  12. Falciglia M, Freyberg RW, Almenoff PL, et al. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Crit Care Med. 2009;37(12):3001–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Kosiborod M, Inzucchi SE, Spertus JA, et al. Elevated admission glucose and mortality in elderly patients hospitalized with heart failure. Circulation. 2009;119(14):1899–907.

    Article  CAS  PubMed  Google Scholar 

  14. Kosiborod M, Rathore SS, Inzucchi SE, et al. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: implications for patients with and without recognized diabetes. Circulation. 2005;111(23):3078–86.

    Article  CAS  PubMed  Google Scholar 

  15. Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(1):16–38.

    Article  CAS  PubMed  Google Scholar 

  16. Baker EH, Janaway CH, Philips BJ, et al. Hyperglycemia is associated with poor outcomes in patients admitted to hospital with acute exacerbations of chronic obstructive pulmonary disease. Thorax. 2006;61(4):284–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Clement S, Braithwaite SS, Magee MF, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553–91.

    Article  PubMed  Google Scholar 

  18. McAlister FA, Majumdar SR, Blitz S, et al. The relation between hyperglycemia and outcomes in 2,471 patients admitted to the hospital with community-acquired pneumonia. Diabetes Care. 2005;28(4):810–5.

    Article  PubMed  Google Scholar 

  19. McAlister FA, Man J, Bisritz L, et al. Diabetes and coronary artery bypass surgery: an examination of perioperative glycemic control and outcomes. Diabetes Care. 2003;26(5):1518–24.

    Article  PubMed  Google Scholar 

  20. Pomposelli JJ, Baxter JK, Babineau TJ, et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. J Parenter Enter Nutr. 1998;22(2):77–81.

    Article  CAS  Google Scholar 

  21. Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 2004;10(Suppl 2):21–33.

    Article  PubMed  Google Scholar 

  22. Krinsley JS, Jones RL. Cost analysis of intensive glycemic control in critically ill adult patients. Chest. 2006;129(3):644–50.

    Article  PubMed  Google Scholar 

  23. Dungan KM, Braithwaite SS, Preiser JC. Stress hyperglycemia. Lancet. 2009;373(9677):1798–807.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Mizock BA. Blood glucose management during critical illness. Rev Endocr Metab Disord. 2003;4(2):187–94.

    Article  CAS  PubMed  Google Scholar 

  25. Cook CB, Kongable GL, Potter DJ, et al. Inpatient glucose control: a glycemic survey of 126 U.S. hospitals. J Hosp Med. 2009;4(9):E7–E14.

    Article  PubMed  Google Scholar 

  26. Schmeltz LR, DeSantis AJ, Thiyagarajan V, et al. Reduction of surgical mortality and morbidity in diabetic patients undergoing cardiac surgery with a combined intravenous and subcutaneous insulin glucose management strategy. Diabetes Care. 2007;30(4):823–8.

    Article  CAS  PubMed  Google Scholar 

  27. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359–67.

    Article  PubMed  Google Scholar 

  28. De La Rosa Gdel C, Donaldo JH, Restrepo AH, et al. Strict glycaemic control in patients hospitalized in a mixed medical and surgical intensive care unit: a randomized clinical trial. Crit Care. 2008;12(5):R120.

    Article  PubMed  Google Scholar 

  29. Inzucchi SE. Clinical practice. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006;355(18):1903–11.

    Article  CAS  PubMed  Google Scholar 

  30. van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354(5):449–61.

    Article  PubMed  Google Scholar 

  31. Preiser JC, Devos P, Ruiz-Santana S, et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med. 2009;35(10):1738–48.

    Article  CAS  PubMed  Google Scholar 

  32. American Diabetes Association. Diabetes care in the hospital: standards of medical care in diabetes - 2021. Diabetes Care. 2021;44(Suppl 1):S211–20.

    Article  Google Scholar 

  33. Saudek CD, Herman WH, Sacks DB, et al. A new look at screening and diagnosing diabetes mellitus. J Clin Endocrinol Metab. 2008;93(7):2447–53.

    Article  CAS  PubMed  Google Scholar 

  34. Ainla T, Baburin A, Teesalu R, Rahu M. The association between hyperglycaemia on admission and 180-day mortality in acute myocardial infarction patients with and without diabetes. Diabet Med. 2005;22(10):1321–5.

    Article  CAS  PubMed  Google Scholar 

  35. Norhammar A, Tenerz A, Nilsson G, et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002;359(9324):2140–4.

    Article  CAS  PubMed  Google Scholar 

  36. Fushimi N, Shibuya T, Yoshida Y, et al. Dulaglutide-combined basal plus correction insulin therapy contributes to ideal glycemic control in non-critical hospitalized patients. J Diab Invest. 2020;11(1):123–31.

    Google Scholar 

  37. Fayfman M, Galindo RJ, Rubin DJ, et al. A randomized controlled trial on the safety and efficacy of exenatide therapy for the inpatient management of general medicine and surgery patients with type 2 diabetes. Diabetes Care. 2019;42(3):450–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Vellanki P, Rasouli N, Baldwin D, et al. Glycaemic efficacy and safety of linagliptin compared to basal-bolus insulin regimen in patients with type 2 diabetes undergoing non-cardiac surgery: a multicentre randomized clinical trial. Diabetes Obes Metab. 2019;21(4):837–43.

    Article  CAS  PubMed  Google Scholar 

  39. Perez-Belmonte LM, Osuna-Sanchez J, Millan-Gomez M, et al. Glycaemic efficacy and safety of linagliptin for the management of non-cardiac surgery patients with type 2 diabetes in a real-world setting: Lina-Surg study. Ann Med. 2019;51(3–4):252–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. U.S. Food and Drug Administration. FDA drug safety communication: FDA adds warnings about heart failure risk to labels of type 2 diabetes medicines containing saxagliptin and alogliptin. Silver Spring, MD: FDA; n.d.. http://www.fda.gov/Drugs/DrugSafety/ucm486096.htm. Accessed 30 Apr 2021.

  41. Horton WB, Subauste JS. Top 10 facts to know about inpatient glycemic control. Am J Med. 2016;129(2):139–42.

    Article  PubMed  Google Scholar 

  42. Schnipper JL, Ndumele CD, Liang CL, Pendergrass ML. Effects of a subcutaneous insulin protocol, clinical education, and computerized order set on the quality of inpatient management of hyperglycemia: results of a clinical trial. J Hosp Med. 2009;4(1):16–27.

    Article  PubMed  Google Scholar 

  43. Maynard G, Lee J, Phillips G, et al. Improved inpatient use of basal insulin, reduced hypoglycemia, and improved glycemic control: effect of structured subcutaneous insulin orders and an insulin management algorithm. J Hosp Med. 2009;4(1):3–15.

    Article  PubMed  Google Scholar 

  44. Umpierrez GE, Smiley D, Jacobs S, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes undergoing general surgery (RABBIT 2 surgery). Diabetes Care. 2011;34(2):256–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Umpierrez GE, Smiley D, Zisman A, et al. Randomized study of basal-bolus insulin therapy in the inpatient management of patients with type 2 diabetes (RABBIT 2 trial). Diabetes Care. 2007;30(9):2181–6.

    Article  CAS  PubMed  Google Scholar 

  46. Baldwin D, Villanueva G, McNutt R, Bhatnagar S. Eliminating inpatient sliding scale insulin: a reeducation project with medical house staff. Diabetes Care. 2005;28(5):1008–11.

    Article  PubMed  Google Scholar 

  47. Umpierrez GE, Palacio A, Smiley D. Sliding scale insulin use: myth or insanity? Am J Med. 2007;120(7):563–7.

    Article  PubMed  Google Scholar 

  48. Queale WS, Seidler AJ, Brancati FL. Glycemic control and sliding scale insulin use in medical inpatients with diabetes mellitus. Arch Intern Med. 1997;157(5):545–52.

    Article  CAS  PubMed  Google Scholar 

  49. Gearhart JG, Duncan JL III, Replogle WH, et al. Efficacy of sliding scale insulin therapy: a comparison with prospective regimens. Fam Pract Res J. 1994;14(4):313–22.

    CAS  PubMed  Google Scholar 

  50. Sawin CT. Action without benefit. The sliding scale of insulin use. Arch Intern Med. 1996;157(5):489.

    Article  Google Scholar 

  51. Nau KC, Lorenzetti RC, Cucuzzella M, et al. Glycemic control in hospitalized patients not in intensive care: beyond sliding-scale insulin. Am Fam Physician. 2010;81(9):1130–5.

    PubMed  Google Scholar 

  52. Schnipper JL, Barsky EE, Shaykevich S, et al. Inpatient management of diabetes and hyperglycemia among general medicine patients at a large teaching hospital. J Hosp Med. 2006;1(3):145–50.

    Article  PubMed  Google Scholar 

  53. Lubitz CC, Seley JJ, Rivera C, et al. The perils of inpatient hyperglycemia management: how we turned apathy into action. Diab Spectr. 2007;20(1):18–21.

    Article  Google Scholar 

  54. Curll M, Dinardo M, Noschese M, Korytkowski MT. Menu selection, glycaemic control and satisfaction with standard and patient-controlled consistent carbohydrate meal plans in hospitalised patients with diabetes. Qual Saf Health Care. 2010;19(4):355–9.

    Article  PubMed  Google Scholar 

  55. Seley JJ, D’hondt N, Longo R, et al. AADE position statement: inpatient glycemic control. Diab Educ. 2009;35(Suppl 3):64S–8S.

    Google Scholar 

  56. Donihi AC, Raval D, Saul M, et al. Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocr Pract. 2006;12(4):358–62.

    Article  PubMed  Google Scholar 

  57. Dungan K, Chapman J, Braithwaite SS, Buse J. Glucose measurement: confounding issues in setting targets for inpatient management. Diabetes Care. 2007;30(2):403–9.

    Article  PubMed  Google Scholar 

  58. Scott MG, Bruns DE, Boyd JC, Sacks DB. Tight glucose control in the intensive care unit: are glucose meters up to the task? Clin Chem. 2009;55(1):18–20.

    Article  CAS  PubMed  Google Scholar 

  59. Vlasselaers D, Herpe TV, Milants I, et al. Blood glucose measurements in arterial blood of intensive care unit patients submitted to tight glycemic control: agreement between bedside tests. J Diabetes Sci Technol. 2008;2(6):932–8.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Cembrowski GS, Tran DV, Slater-Maclean L, et al. Could susceptibility to low hematocrit interference have compromised the results of the NICE-SUGAR trial? Clin Chem. 2010;56(7):1193–5.

    Article  CAS  PubMed  Google Scholar 

  61. Cook CB, Castro JC, Schmidt RE, et al. Diabetes care in hospitalized noncritically ill patients: more evidence for clinical inertia and negative therapeutic momentum. J Hosp Med. 2007;2(4):203–11.

    Article  PubMed  Google Scholar 

  62. Gomez AM, Umpierrez GE. Continuous glucose monitoring in insulin-treated patients in non-ICU settings. J Diabetes Sci Technol. 2014;8(5):940–6.

    Article  Google Scholar 

  63. Gomez AM, Umpierrez GE, Munoz OM, et al. Continuous glucose monitoring versus capillary point-of-care testing for inpatient glycemic control in type 2 diabetes patients hospitalized in the general ward and treated with a basal bolus insulin regimen. J Diabetes Sci Technol. 2016;10(2):325–9.

    Article  CAS  Google Scholar 

  64. Levitt DL, Spanakis EK, Ryan KA, Silver KD. Insulin pump and continuous glucose monitor initiation in hospitalized patients with type 2 diabetes mellitus. Diabetes Technol Ther. 2018;20(1):32–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Dexcom. FDA grants breakthrough device designation for Dexcom Hospital CGM system. 2022. https://investors.dexcom.com/news-releases/news-release-details/fda-grants-breakthrough-device-designation-dexcom-hospital-cgm. Press release.

  66. Korytkowski MT, Salata RJ, Koerbel GL, et al. Insulin therapy and glycemic control in hospitalized patients with diabetes during enteral nutrition therapy: a randomized controlled clinical trial. Diabetes Care. 2009;32(4):594–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Umpierrez GE, Hor T, Smiley D, et al. Comparison of inpatient insulin regimens with detemir plus aspart versus neutral protamine Hagedorn plus regular in medical patients with type 2 diabetes. J Clin Endocrinol Metab. 2009;94(2):564–9.

    Article  CAS  PubMed  Google Scholar 

  68. Umpierrez GE, Smiley D, Hermayer K, et al. Randomized study comparing a basal-bolus with a basal plus correction insulin regimen for the hospital management of medical and surgical patients with type 2 diabetes: basal plus trial. Diabetes Care. 2013;36(8):2169–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Maynard G, Wesorick DH, O’Malley C, et al. Subcutaneous insulin order sets and protocols: effective design and implementation strategies. J Hosp Med. 2008;3(5 Suppl):29–41.

    Article  PubMed  Google Scholar 

  70. Schafer RG, Bohannon B, Franz MJ, et al. Diabetes nutrition recommendations for health care institutions. Diabetes Care. 2004;27(Suppl 1):S55–7.

    PubMed  Google Scholar 

  71. Gosmanov AR, Umpierrez GE. Medical nutrition therapy in hospitalized patients with diabetes. Curr Diab Rep. 2012;12(1):93–100.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Schafer RG, Bohannon B, Franz MJ, et al. Translation of the diabetes nutrition recommendations for health care institutions. Diabetes Care. 2003;26(Suppl 1):S70–2.

    PubMed  Google Scholar 

  73. Boucher JL, Swift CS, Franz MJ, et al. Inpatient management of diabetes and hyperglycemia: implications for nutrition practice and the food and nutrition professional. J Am Diet Assoc. 2007;107(1):105–11.

    Article  PubMed  Google Scholar 

  74. Ziegler TR. Parenteral nutrition in the critically ill patient. N Engl J Med. 2009;361(11):1088–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Draznin B, Korytkowski M, Draznin B, Drincic A. Food, fasting, insulin, and glycemic control in the hospital. In: Draznin B, editor. Managing diabetes and hyperglycemia in the hospital setting. Alexandria, VA: American Diabetes Association; 2016. p. 70–83.

    Google Scholar 

  76. Noschese M, Donihi AC, Koerbel G, et al. Effect of a diabetes order set on glycaemic management and control in the hospital. Qual Saf Health Care. 2008;17(6):464–8.

    Article  CAS  PubMed  Google Scholar 

  77. Kreider KE, Lien LF. Transitioning safely from intravenous to subcutaneous insulin. Curr Diab Rep. 2015;15(5):23.

    Article  PubMed  Google Scholar 

  78. Clain J, Ramar K, Surani SR. Glucose control in critical care. World J Diabetes. 2015;6(9):1082–91.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Kavanagh BP, McCowen KC. Clinical practice. Glycemic control in the ICU. N Engl J Med. 2010;363(26):2540–6.

    Article  CAS  PubMed  Google Scholar 

  80. Lena D, Kalfon P, Preiser JC, Ichai C. Glycemic control in the intensive care unit and during the postoperative period. Anesthesiology. 2011;114(2):438–44.

    Article  PubMed  Google Scholar 

  81. McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin. 2001;17(1):107–24.

    Article  CAS  PubMed  Google Scholar 

  82. Stuart CA, Shangraw RA, Prince MJ, et al. Bed-rest-induced insulin resistance occurs primarily in muscle. Metab Clin Exp. 1988;37(8):802–6.

    Article  CAS  PubMed  Google Scholar 

  83. Finfer S, Wernerman J, Preiser JC, et al. Clinical review: consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults. Crit Care. 2013;17(3):229.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Kanji S, Buffie J, Hutton B, et al. Reliability of point-of-care testing for glucose measurement in critically ill adults. Crit Care Med. 2005;33(12):2778–85.

    Article  PubMed  Google Scholar 

  85. Hoedermaekers CW, Klein Gunnewiek JM, Prinsen MA, et al. Accuracy of bedside glucose measurement from three glucometers in critically ill patients. Crit Care Med. 2008;36(11):3062–6.

    Article  Google Scholar 

  86. Finkielman JD, Oyen LJ, Afessa B. Agreement between bedside blood and plasma glucose measurement in the ICU setting. Chest. 2005;127(5):1749–51.

    Article  PubMed  Google Scholar 

  87. Lyon ME, Baskin LB, Braakman S, et al. Interference studies with two hospital-grade and two home-grade glucose meters. Diabetes Technol Ther. 2009;11(10):641–7.

    Article  PubMed  Google Scholar 

  88. Karon BS, Gandhi GY, Nuttall GA, et al. Accuracy of Roche Accu-check inform whole blood capillary, arterial, and venous glucose values in patients receiving intensive intravenous insulin therapy after cardiac surgery. Am J Clin Pathol. 2007;127(6):919–26.

    Article  CAS  PubMed  Google Scholar 

  89. Ehrhardt N, Hirsch IB. The impact of COVID-19 on CGM use in the hospital. Diabetes Care. 2020;43(11):2628–30.

    Article  CAS  PubMed  Google Scholar 

  90. Agarwal S, Mathew J, Davis GM, et al. Continuous glucose monitoring in the intensive care unit during the COVID-19 pandemic. Diabetes Care. 2021;44(3):847–9.

    Article  CAS  PubMed  Google Scholar 

  91. Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360(13):1283–97.

    Article  PubMed  Google Scholar 

  92. Green DM, O’Phelan KH, Bassin SL, et al. Intensive versus conventional insulin therapy in critically ill neurologic patients. Neurocrit Care. 2010;13(3):299–306.

    Article  CAS  PubMed  Google Scholar 

  93. Coester A, Neumann CR, Schmidt MI. Intensive insulin therapy in severe traumatic brain injury: a randomized trial. J Trauma. 2010;68(4):904–11.

    CAS  PubMed  Google Scholar 

  94. Macrae D, Grieve R, Allen E, et al. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med. 2014;370(2):107–18.

    Article  CAS  PubMed  Google Scholar 

  95. Goldberg PA, Siegel MD, Sherwin RS, et al. Implementation of a safe and effective insulin infusion protocol in a medical intensive care unit. Diabetes Care. 2004;27(2):461–7.

    Article  CAS  PubMed  Google Scholar 

  96. Rea RS, Donihi AC, Bobeck M, et al. Implementing an intravenous insulin infusion protocol in the intensive care unit. Am J Health Syst Pharm. 2007;64(4):385–95.

    Article  PubMed  Google Scholar 

  97. Nazer LH, Chow SL, Moghissi ES. Insulin infusion protocols for critically ill patients: a highlight of differences and similarities. Endocr Pract. 2007;13(2):137–46.

    Article  PubMed  Google Scholar 

  98. DeSantis AJ, Schmeltz LR, Schmidt K, et al. Inpatient management of hyperglycemia: the Northwestern experience. Endocr Pract. 2006;12(5):491–505.

    Article  PubMed  Google Scholar 

  99. Furnary AP, Braithwaite SS. Effects of outcome on in-hospital transition from intravenous insulin infusion to subcutaneous therapy. Am J Cardiol. 2006;98(4):557–64.

    Article  CAS  PubMed  Google Scholar 

  100. Smiley DD, Umpierrez GE. Perioperative glucose control in the diabetic or nondiabetic patient. South Med J. 2006;99(6):580–9.

    Article  PubMed  Google Scholar 

  101. Marchant MH, Viens NA, Cook C, et al. The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. J Bone Joint Surg Am. 2009;91(7):1621–9.

    Article  PubMed  Google Scholar 

  102. Gandhi GY, Nuttall GA, Abel MD, et al. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc. 2005;80(7):862–6.

    Article  PubMed  Google Scholar 

  103. Pichardo-Lowden A, Gabbay RA. Management of hyperglycemia during the perioperative period. Curr Diab Rep. 2012;12(1):108–18.

    Article  CAS  PubMed  Google Scholar 

  104. Malmstedt J, Wahlberg E, Jorneskog G, Swedenborg J. Influence of perioperative blood glucose levels on outcome after infrainguinal bypass surgery in patients with diabetes. Br J Surg. 2006;93(11):1360–7.

    Article  CAS  PubMed  Google Scholar 

  105. Sebranek JJ, Lugli AK, Coursin DB. Glycaemic control in the perioperative period. Br J Anaesth. 2013;111(Suppl 1):i18–34.

    Article  CAS  PubMed  Google Scholar 

  106. Hatzakorzian R, Bui H, Carvalho G, et al. Fasting blood glucose levels in patients presenting for elective surgery. Nutrition. 2011;27(3):298–301.

    Article  CAS  PubMed  Google Scholar 

  107. World Health Organization. World Health Organization guidelines for safe surgery. Geneva: World Health Organization; 2009.

    Google Scholar 

  108. Aldam P, Levy N, Hall GM. Perioperative management of diabetic patients: new controversies. Br J Anaesth. 2014;113(6):906–9.

    Article  CAS  PubMed  Google Scholar 

  109. Mucha GT, Merkel S, Thomas W, Bantle JP. Fasting and insulin glargine in individuals with type 1 diabetes. Diabetes Care. 2004;27(5):1209–10.

    Article  PubMed  Google Scholar 

  110. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235–9.

    Article  PubMed  Google Scholar 

  111. Pancorbo-Hidalgo PL, Garcia-Fernandez FP, Ramirez-Perez C. Complications associated with enteral nutrition by nasogastric tube in an internal medicine unit. J Clin Nurs. 2001;10(4):482–90.

    Article  CAS  PubMed  Google Scholar 

  112. Umpierrez GE. Basal versus sliding-scale regular insulin in hospitalized patients with hyperglycemia during enteral nutrition therapy. Diabetes Care. 2009;32(4):751–3.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Clore JN, Thurby-Hay L. Glucocorticoid-induced hyperglycemia. Endocr Pract. 2009;15(5):469–74.

    Article  PubMed  Google Scholar 

  114. Felig P, Sherwin RS, Soman V, et al. Hormonal interactions in the regulation of blood glucose. Recent Prog Horm Res. 1979;35:501–32.

    CAS  PubMed  Google Scholar 

  115. Schade DS, Eaton RP. The temporal relationship between endogenously secreted stress hormones and metabolic decompensation in diabetic man. J Clin Endocrinol Metab. 1980;50(1):131–6.

    Article  CAS  PubMed  Google Scholar 

  116. Umpierrez GE, Kitabchi AE. ICU care for patients with diabetes. Curr Opin Endocrinol Diab. 2004;11(2):75–81.

    Article  Google Scholar 

  117. Suh S, Park MK. Glucocorticoid-induced diabetes mellitus: an important but overlooked problem. Endocrinol Metab. 2017;32(2):180–9.

    Article  CAS  Google Scholar 

  118. Cook CB, Boyle ME, Cisar NS, et al. Use of continuous subcutaneous insulin infusion (insulin pump) therapy in the hospital setting: proposed guidelines and outcome measures. Diab Educ. 2005;31(6):849–57.

    Article  Google Scholar 

  119. Bailon RM, Partlow BJ, Miller-Cage V, et al. Continuous subcutaneous insulin infusion (insulin pump) therapy can be safely used in the hospital in select patients. Endocr Pract. 2009;15(1):24–9.

    Article  PubMed  Google Scholar 

  120. Boucai L, Southern WN, Zonszein J. Hypoglycemia-associated mortality is not drug-associated but linked to comorbidities. Am J Med. 2011;124(11):1028–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  121. Garg R, Hurwitz S, Turchin A, Trivedi A. Hypoglycemia, with or without insulin therapy, is associated with increased mortality among hospitalized patients. Diabetes Care. 2013;36(5):1107–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  122. Turchin A, Matheny ME, Shubina M, et al. Hypoglycemia and clinical outcomes in patients with diabetes hospitalized in the general ward. Diabetes Care. 2009;32(7):1153–7.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Smith WD, Winterstein AG, Johns T, et al. Causes of hyperglycemia and hypoglycemia in adult inpatients. Am J Health Syst Pharm. 2005;62(7):714–9.

    Article  PubMed  Google Scholar 

  124. van der Crabben SN, Blumer RM, Stegenga ME, et al. Early endotoxemia increases peripheral and hepatic insulin sensitivity in healthy humans. J Clin Endocrinol Metab. 2009;94(2):463–8.

    Article  PubMed  Google Scholar 

  125. Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94(3):709–28.

    Article  CAS  PubMed  Google Scholar 

  126. Mitrakou A, Ryan C, Veneman T, et al. Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction. Am J Phys. 1991;260(1 Pt 1):E67–74.

    CAS  Google Scholar 

  127. Arnold P, Scheurer D, Dake AW, et al. Hospital guidelines for diabetes management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification. Am J Med Sci. 2016;351(4):333–41.

    Article  PubMed  Google Scholar 

  128. Shah BR, Walji S, Kiss A, et al. Derivation and validation of a risk-prediction tool for hypoglycemia in hospitalized adults with diabetes: the Hypoglycemia during Hospitalization (HyDHo) Score. Can J Diabetes. 2019;43(4):278–82.

    Article  PubMed  Google Scholar 

  129. Mathioudakis NM, Everett E, Routh S, et al. Development and validation of a prediction model for insulin-associated hypoglycemia in non-critically ill hospitalized adults. BMJ Open Diabetes Res Care. 2018;6(1):e000499.

    Article  PubMed  PubMed Central  Google Scholar 

  130. Ruan Y, Bellot A, Moysova Z, et al. Predicting the risk of inpatient hypoglycemia with machine learning using electronic health records. Diabetes Care. 2020;43(7):1504–11.

    Article  CAS  PubMed  Google Scholar 

  131. Mathioudakis NM, Abusamaan MS, Shakarchi AF, et al. Development and validation of a machine learning model to predict near-term risk of iatrogenic hypoglycemia in hospitalized patients. JAMA Netw Open. 2021;4(1):e2030913.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Horton WB, Barros AJ, Andris RT, et al. Pathophysiologic signature of impending ICU hypoglycemia in bedside monitoring and electronic health record data: model development and validation. Crit Care Med. 2022;50(3):e221–30.

    Article  CAS  PubMed  Google Scholar 

  133. Kilpatrick CR, Elliott MB, Pratt E, et al. Prevention of inpatient hypoglycemia with a real-time informatics alert. J Hosp Med. 2014;9(10):621–6.

    Article  PubMed  Google Scholar 

  134. Schnipper JL, Magee M, Larsen K, et al. Society of Hospital Medicine Glycemic Control Task Force summary: practical recommendations for assessing the impact of glycemic control efforts. J Hosp Med. 2008;3(5 Suppl):66–75.

    Article  PubMed  Google Scholar 

  135. Lauster CD, Gibson JM, DiNella JV, et al. Implementation of standardized instructions for insulin at hospital discharge. J Hosp Med. 2009;4(8):E41–2.

    Article  PubMed  Google Scholar 

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  1. Medicine, Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA

    William B. Horton

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    Joel Rodriguez-Saldana

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Horton, W.B. (2023). Inpatient Management of Diabetes and Hyperglycemia. In: Rodriguez-Saldana, J. (eds) The Diabetes Textbook. Springer, Cham. https://doi.org/10.1007/978-3-031-25519-9_46

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