Targeted Glycemic Control for Adult Patients With Type 2 Diabetes Mellitus in the Acute Care Setting

Diabetes mellitus and complications arising from the disease are a leading cause of morbidity and mortality worldwide. With increasing prevalence over the past 50 years and an estimated 20% of health-care spending dedicated to the disease, diabetes is considered by many to be a true public health emergency. Several protocols and management options exist to maximize glycemic control in the ambulatory setting, but the optimal glucose level in critically and noncritically ill inpatients is still debated. This review examines the evidence behind differing degrees of glycemic control across a variety of hospital settings and clinical scenarios. Patients presenting to the emergency department who are found to be hyperglycemic pose additional management challenges for clinicians. In this setting, no consensus exists for optimal serum glucose level and safe discharge parameters.