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Hyperglycemia

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Figure 1. Hyperglycemia – In-Hospital Management POC testing for ≥ 24-48 h Continue POC testing AC & at bedtime if eating q4-6h if NPO or continuous EN Medical nutrition therapy Insulin only (by protocol) Treatment HbA1c > 7.8 mmol/L (140 mg/dL) Critical care Severe/persistent hyperglycemia Perioperative Noncritical care EN or PN CII Basal/Bolus/Correction Continue POC testing Targets* Fasting : < 7.8 mmol/L (140 mg/dL) Random: < 10 mmol/L (180 mg/dL) mg/dL = mmol/L × 18 Reassess if BG < 5.6 mmol/L (100 mg/dL) or > 10 mmol/L (180 mg/dL) * Subject to individual variation Post-transition regimen ≥ 1 day before discharge Patient & family self-care instructions (oral and written ) Discharge Corticosteroids, octreotide, EN or PN History of diabetes BG > 7.8 mmol/L (140 mg/dL)

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