الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hyperglycemia is known to be associated with increased mortality, longer hospital stays, and increased complications. Despite these factors, it is often inadequately addressed in the inpatient setting. Standards of inpatient care now specify regular monitoring for hyperglycemia combined with appropriate management strategies.Typically, oral agents should be discontinued during acute illness unless it is a very brief hospitalization. Oral agents can be restarted as patients approach discharge or transfer to non-acute setting. Metformin cannot be used when there is any possibility of the need for iodinated contrast studies or renal insufficiency. Sulfonylureas and metaglinides can cause unpredictable hypoglycemia in patients who are not eating reliably. Thiazolidinedione can cause fluid retention, especially in combination with insulin. Parenteral glucagon-like peptide-1 and amylin agonists can cause nausea and should be withheld in acutely ill patients. For these reasons, inpatient hyperglycemia is best managed with insulin only.Insulin is the most commonly used medication to manage hyperglycemia and diabetes in hospitalized patients. The appropriate use of insulin will control and prevent glucose excursions. Understanding the relationship of the action, peak, and duration of the different types of insulin will assist in the development of an individualized care plan to assist the patient not only in inpatient blood glucose level management but also in self-management care after discharge.Continuous IV insulin infusion is recommended for critically ill patients to allow rapid adjustments in insulin dose to meet changing requirements and maintain glycemic targets. As patients recover, they can be transitioned from IV insulin to subcutaneous insulin.