Diabetes in hospital

Abstract

Up to 10% of NHS inpatients have diabetes. It is unrealistic to expect every patient to have normal blood glucose all the time; we define good control as four out of five preprandial glucose values in the range 4-10 mmol/l. Acutely ill patients should be managed with intravenous insulin/dextrose. Patients well enough to eat should be treated with subcutaneous insulin; a four times daily 'basal-bolus' regimen reduces the glucose rise after meals and is flexible enough to be adjusted within-day to correct for any upwards or downwards trend. Analogues are showing promise as the insulins of choice for patients in hospital.