Hospital Management of Diabetes

Holly Bashura, CRNP, Terri P. Kemmerer, RN, MS, CRNP, CDE, Sherita Golden, M.D., M.H.S.
Hospital Management of Diabetes is a topic covered in the Johns Hopkins Diabetes Guide.

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DEFINITION

  • Goal of inpatient management: achieving a level of glycemic control that will improve patient outcomes, while reducing the risk of either hypoglycemia or iatrogenic diabetic ketoacidosis (DKA).
  • In critically ill patients: 2015 ADA recommendations: intravenous (IV) insulin infusion to control hyperglycemia targeting 140 - 180 mg/dL (target < 110 mg/ dL is no longer recommended)[5].
  • In non-critically ill patients: 2015 ADA recommendation: premeal target < 140 mg/dL, random BG < 180 mg/dL; if BG < 100, consider reassessing insulin regimen; if BG < 70, regimen should be modified.

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DEFINITION

  • Goal of inpatient management: achieving a level of glycemic control that will improve patient outcomes, while reducing the risk of either hypoglycemia or iatrogenic diabetic ketoacidosis (DKA).
  • In critically ill patients: 2015 ADA recommendations: intravenous (IV) insulin infusion to control hyperglycemia targeting 140 - 180 mg/dL (target < 110 mg/ dL is no longer recommended)[5].
  • In non-critically ill patients: 2015 ADA recommendation: premeal target < 140 mg/dL, random BG < 180 mg/dL; if BG < 100, consider reassessing insulin regimen; if BG < 70, regimen should be modified.

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Last updated: May 28, 2016