Annals for Hospitalists Inpatient Notes - How We Treat Hyperglycemia in the Hospital
Authors: Francisco J. Pasquel, Guillermo E. Umpierrez
Journal: Annals of Internal Medicine (2021)

Web ExclusivesAugust 2021Annals for Hospitalists Inpatient Notes - How We Treat Hyperglycemia in the HospitalFrancisco J. Pasquel, MD, MPH and Guillermo E. Umpierrez, MD, CDEFrancisco J. Pasquel, MD, MPHEmory University School of Medicine, Atlanta, Georgia (F.J.P., G.E.U.). and Guillermo E. Umpierrez, MD, CDEEmory University School of Medicine, Atlanta, Georgia (F.J.P., G.E.U.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-2789 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A 76-year-old man with type 2 diabetes mellitus (T2D) is admitted for pneumonia. At home, he receives metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor. His body mass index is 24 kg/m2, admission blood glucose (BG) level is 14.98 mmol/L (270 mg/dL), hemoglobin A1c level is 8.2%, and serum creatinine level is 123.76 μmol/L (1.4 mg/dL) (estimated glomerular filtration rate, 45 mL/min). The admitting team withdraws his oral agents and starts sliding-scale insulin (SSI) therapy. After 24 hours, his BG levels are consistently above 11.10 mmol/L (>200 mg/dL).Diabetes is a common diagnosis among hospitalized patients that is associated with poor ...References1. Pasquel FJ, Lansang MC, Dhatariya K, et al. Management of diabetes and hyperglycaemia in the hospital. Lancet Diabetes Endocrinol. 2021;9:174-188. [PMID: 33515493] doi:10.1016/S2213-8587(20)30381-8 CrossrefMedlineGoogle Scholar2. Umpierrez GE, Hellman R, Korytkowski MT, et al; Endocrine Society. Management of hyperglycemia in hospitalized patients in non-critical care setting: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:16-38. [PMID: 22223765] doi:10.1210/jc.2011-2098 CrossrefMedlineGoogle Scholar3. Umpierrez GE, Smiley D, Hermayer K, et al. Randomized study comparing a basal-bolus with a basal plus correction insulin regimen for the hospital management of medical and surgical patients with type 2 diabetes: basal plus trial. Diabetes Care. 2013;36:2169-74. [PMID: 23435159] doi:10.2337/dc12-1988 CrossrefMedlineGoogle Scholar4. Pasquel FJ, Gianchandani R, Rubin DJ, et al. Efficacy of sitagliptin for the hospital management of general medicine and surgery patients with type 2 diabetes (Sita-Hospital): a multicentre, prospective, open-label, non-inferiority randomised trial. Lancet Diabetes Endocrinol. 2017;5:125-133. [PMID: 27964837] doi:10.1016/S2213-8587(16)30402-8 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Emory University School of Medicine, Atlanta, Georgia (F.J.P., G.E.U.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-2789.Corresponding Author: Guillermo E. Umpierrez, MD, CDE, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - August 2021 Megan Mack , Matthew Luzum , and David H. Wesorick Metrics Cited byAmerican Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 UpdateManagement of Hyperglycemia in Hospitalized, Non–Critically Ill AdultsSafety and Efficacy of Inpatient Diabetes Management with Non-insulin Agents: an Overview of International Practices August 2021Volume 174, Issue 8Page: HO2-HO4KeywordsGlucoseHbA1cHospital medicineHyperglycemiaHypoglycemiaInsulinType 2 diabetes ePublished: 17 August 2021 Issue Published: August 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...