Diabetes Mellitus | Guidelines for Hospital Admission

Age of the patient

Gender of the patient

Fasting plasma glucose at presentation

Arterial pH

Serum bicarbonate at presentation in mEq/L

Is ketonuria or ketonemia present?

Plasma omolality in mOsm per kg water

Has the patient just experienced impaired mental status, coma, altered behavior or seizures?

Has the patient responded promptly to therapy?

Is a responsible adult available to be with the patient for the next 12 hours?

Was the hypoglcyemia caused by a sulfonylurea drug?

Is the hyperglycemia associated with volume depletion?

Has the patient had persistent, refractory hyperglycemia associated with metabolic deterioration?

Has the patient had recurrent fasting hyperglycemia refractory to outpatient therapy?

Has the patient had recurring episodes of severe hypoglycemia?

Has the patient shown frequent swings between hypoglycemia and hyperglycemia?

Has the patient had recurring episodes of diabetic ketoacidosis without precipitating infection or trauma?

Has the patient had severe psychosocial problems with poor metabolic control that cannot be managed as an outpatient?

Does the patient have a condition for which the outcome is significantly improved by rigorous control of diabetes?

Does the patient have a condition associated directly or through therapy with a significant problem with diabetic control?

Is the patient pregnant?

Has the patient had an acute onset of a diabetic complication affecting the eyes, kidney, heart or brain?

Does the patient have an severe end-stage organ failure secondary diabetes?

Has diabetes been newly diagnosed in the patient?

Is the patient being started on insulin pump therapy?

Are there other psychosocial factors that make admission necessary?