Glycaemic management in patients with diabetes in hospital

Abstract

Approximately 20–30% of all acute hospital beds in England and Wales are occupied by people with diabetes mellitus, despite the condition only affecting roughly 6.5% of the UK population. This high prevalence means that diabetes patients are significantly overrepresented in inpatient settings, often requiring specialized care for the presenting condition unrelated to their diabetes as well as direct metabolic consequences of diabetes mellitus, including hyperglycaemia and hypoglycaemic episodes arising during the admission. Consequently, diabetes is associated not only with a considerable increase in morbidity and mortality, but also an increase in cost related to healthcare delivery and length of stay. National organizations, such as the Joint British Diabetes Societies for Inpatient Care, American Diabetes Association and Endocrine Society, have recognized this increasing problem and have produced guidelines and consensus statements for improving inpatient care. This overview of inpatient diabetes management focuses on current practices in the UK and gives recommendations for improving diabetes care, including the choice of various diabetes therapies and technologies, as well as summarizing newer evolving topics of perioperative care.