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Updated: May 22, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Glycemic management in the inpatient setting
Lowell R Schmeltz1, Carla Ferrise
1Assistant Professor, Oakland University William Beaumont School of Medicine, Rochester, MI; Associated Endocrinologists, PC and Endocrine Hospital Consultants, PC, West Bloomfield, MI; Chief of Endocrinology, Detroit Medical Center-Huron Valley-Sinai Hospital, Commerce, MI; Department of Endocrinology, William Beaumont Hospital, Royal Oak, MI. schmeltz@endocrinemds.com.
Hospital Practice (1995)
|May 23, 2012
Summary
Hospitalized patients with hyperglycemia should receive insulin therapy, with careful monitoring to avoid hypoglycemia. Optimal glycemic control requires a multidisciplinary approach and institutional support for safe insulin use.
Area of Science:
- Internal Medicine
- Endocrinology
- Hospital Management
Background:
- Hyperglycemia is common in hospitalized patients, negatively impacting outcomes like mortality and length of stay.
- Current guidelines recommend a blood glucose target of 140-180 mg/dL for most hospitalized patients.
- Hypoglycemia is a significant concern and an independent risk factor for adverse outcomes.
Purpose of the Study:
- To outline current recommendations for managing hyperglycemia in hospitalized patients.
- To emphasize the importance of insulin as the preferred treatment modality.
- To highlight strategies for preventing hypoglycemia and improving overall glycemic control.
Main Methods:
- Review of consensus statements from major endocrinology organizations.
- Discussion of insulin therapy strategies for critically ill and noncritically ill patients.
- Emphasis on the use of insulin algorithms and hypoglycemia protocols.
Main Results:
- Insulin is the preferred treatment for hyperglycemia in all hospitalized patients.
- Intravenous insulin is recommended for critically ill patients.
- Subcutaneous insulin algorithms are advised for noncritically ill patients, including basal, nutritional, and correctional doses.
Conclusions:
- Achieving optimal glycemic control requires a collaborative effort from all healthcare providers.
- Institutions should implement strategies like insulin algorithms, preprinted orders, and hypoglycemia protocols to ensure safe insulin use.
- Patient and healthcare provider education is crucial for improving glycemic management and patient outcomes.
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