Hyperglycemia Management for the Non-Eating Hospitalized Patient

Abstract

Hyperglycemia in the hospital setting is a common phenomenon and it may reflect already known diabetes, previously unrecognized diabetes or acute illness-hospital related hyperglycemia. It is well known that treatment of in-hospital hyperglycemia has beneficial effects on the shortand long-term outcomes for the patients. The not-eating hospitalized patients should be preferably treated with continuous intravenous glucose and insulin infusion, in order to benefit from the antihyperglycemic and anabolic effects of insulin. The subcutaneous insulin regimes are not preferred, because intravenous insulin can be titrated more quickly and precisely, making the risk of hyperor hypo-glycemia less likely. It should be noticed that glucose derangements are very easy to happen in a hospitalized patient, because of the illness per se, of the alterations in the co-administered regiment, etc. In conclusion, algorithms for the treatment of hospitalized, “noteating” patients, especially algorithms addressed to non-diabetesspecialist doctors, should focus on continuous intravenous insulin infusion based on frequent bedside glucose measurements, in order to achieve optimal glucose control.