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Updated: Jul 15, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Hyperglycemia management in the hospital setting
1Pharmacotherapy Services, VISICU, 217 E. Redwood Street, Suite 1900, Baltimore, Maryland 21202, USA. ehassan@visicu.com
Summary
Hospitalized patients with hyperglycemia require proactive management. Continuous intravenous insulin or basal-bolus subcutaneous insulin injections are preferred over sliding-scale insulin for better glycemic control.
Area of Science:
- Internal Medicine
- Endocrinology
Background:
- Hyperglycemia in hospitalized patients poses significant risks.
- Effective glycemic control is crucial for patient outcomes.
Purpose of the Study:
- To provide recommendations for managing blood glucose concentrations in hospitalized patients.
- To discuss factors influencing glycemic control and therapy aggressiveness.
- To evaluate different insulin therapy strategies.
Main Methods:
- Review of target blood glucose concentrations and complicating factors.
- Assessment of oral antihyperglycemic agents, sliding-scale insulin, continuous intravenous insulin infusions, and basal-bolus insulin therapy.
- Consideration of insulin pharmacodynamics and computer decision support systems.
Main Results:
- Target blood glucose concentrations vary based on critical illness status.
- Oral agents and sliding-scale insulin are less effective for in-hospital hyperglycemia.
- Continuous intravenous insulin or basal-bolus subcutaneous insulin therapy is preferred.
Conclusions:
- Sliding-scale insulin is ineffective and potentially dangerous.
- Continuous intravenous or basal-bolus subcutaneous insulin therapy offers superior glycemic control.
- Proactive management is essential for achieving and maintaining target blood glucose levels.
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