The proper management of a diabetic in the hospital involves a number of diagnostic and therapeutic interventions.



(1) regular glucose monitoring (bedside and/or laboratory measurement)

(2) hemoglobin A1c level if not recently measured

(3) screen for diabetic complications (renal, retinal, dermatologic, neurologic)

(4) identify factors contributing to hyperglycemia (steroid or vasopressor therapy, parenteral nutrition, etc)



(1) glucose control using a scheduled dosage insulin regimen, taking steps to avoid hyperglycemia

(1a) ICU: target range 80 to 110 mg/dL (euglycemia)

(1b) cardiac or other major surgery: tight control, especially in the perioperative period

(1c) other patients: fasting glucose < 126 mg/dL and random glucose < 180 mg/dL

(2) detection, avoidance and tracking of hypoglycemic episodes


Discharge planning:

(1) diabetic education

(2) nutrition education

(3) rehabilitation


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