2
Key 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.
Abbreviations
BBI, basal bolus insulin; BG, blood glucose; CC, carbohydrate counting ; CHO, carbohydrate; CGM,
continuous glucose monitoring ; DPP4i, dipeptidyl-peptidase-4 inhibitors; ES, Endocrine Society; GCs,
glucocorticoids; HbA1c, hemoglobin A1c; LOS, length of stay; NPH, neutral protamine Hagedorn; NPO,
nil per os; POC-BG, point-of-care blood glucose; SC, subcutaneous; SSI, sliding scale insulin; T1D, type 1
diabetes; T2D, type 2 diabetes
