Patient description: The patient is a 24-year-old man who has had type 1 diabetes for 11 years. He presents to the emergency room with hyperglycemia and concern for possible diabetic ketoacidosis after not taking his insulin for 3 days. The patient reports that he is currently homeless and has lost his supply of insulin, syringes, glucometer, and glucose testing supplies. The patient states that at the time of his initial diagnosis with type 1 diabetes he was hospitalized with a glucose value >1000 mg/dL. At the time, he was experiencing polyuria, polydipsia, and polyphagia. He reports that he has been on insulin since the time of his diagnosis, and he has never been prescribed oral agents for diabetes management. Most recently, he has been using insulin glargine 55 units once daily, and insulin aspart sliding scale 3 times daily. The patient has had previous episodes of diabetic ketoacidosis, for which he was hospitalized. With this episode of hyperglycemia, he is not experiencing any nausea, vomiting, or abdominal discomfort, and he appears well. His lab studies showed: A1c: 11.3% Creatinine: 0.9 mg/dL with eGFR >60 mL/min Aspartate aminotransferase (AST): 17 U/L Alanine aminotransferase (ALT): 14 U/L Beta-hydroxybutyrate: 0.1 mmol/L Bicarbonate: 25 mEq/L Anion

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Type 2 Diabetes Males or females between > 18 years admitted to a general medicine or surgical service. 2. A known history of T2D treated either with diet alone, oral monotherapy, any combination of oral antidiabetic agents, short-acting GLP1-RA (exenatide, liraglutide) or insulin therapy except for degludec and glargine U300. 3. Medical and surgical patients expected to be admitted length of stay (LOS) longer than 3 days 4. Subjects must have a randomization BG > 140 mg and < 400 mg/dL without laboratory evidence of diabetic ketoacidosis (bicarbonate < 18 mEq/L, pH < 7.30, or positive serum or urinary ketones). 5. Signed, informed consent and HIPAA documentation prior to any study procedures  Subjects with increased BG concentration, but without a known history of diabetes (stress hyperglycemia). 2. Subjects treated with diet alone (no antidiabetic agents) and admission HbA1c <7%. 3. Subjects with a history of diabetic ketoacidosis and hyperosmolar hyperglycemic state, or ketonuria 32. 4. Patients treated with degludec or glargine U300, or with long-acting weekly GLP1-RA (weekly exenatide, dulaglutide or albiglutide). 5. Patients with acute critical or surgical illness admitted to the ICU or expected to require admission to the ICU. 6. Patients with history of clinically relevant hepatic disease (diagnosed liver cirrhosis and portal hypertension), ongoing corticosteroid therapy (equal to a prednisone dose ≥5 mg/day), or impaired renal function (eGFR< 30 ml/min), or congestive heart failure (NYHA IV). 7. Patients with medical and surgical pancreatic disease. 8. Mental condition rendering the subject unable to understand the nature, scope, and possible consequences of the study. 9. Female subjects who are pregnant or breast feeding at time of enrollment into the study. 10. Known or suspected allergy to trial medication(s), excipients, or related products. 11. Previous participation in this trial