Current Recommendations for Insulin Therapy in the Hospitalized Patient.

Abstract

Dysglycemia increases morbidity and mortality in hospitalized patients. Insulin is recommended to manage blood glucose levels greater than or equal to 180 mg/dL. Establishing comprehensive protocols for dysglycemia management in all departments ensures consistent, evidence-based patient care. Basal, prandial, and correction dosing are the best methods for insulin administration. For patients on total parenteral nutrition (TPN) with hyperglycemia, add regular human insulin to the TPN. Corticosteroids can cause hyperglycemia and can be managed with neutral protamine hagedorn insulin. Pay special attention to the resumption of the patient's diet and oral medications during transitions of care and before discharge.