Managing Diabetes Mellitus and Hyperglycemia in Hospitals

Strategic Insights -

Researchers at Emory University have found that diabetes mellitus significantly increases the risk of emergency room visits and hospital admissions. According to the study, inpatient hyperglycemia in patients with or without diabetes mellitus is associated with a higher rate of complications, longer hospital stays, and increased mortality compared to patients with normoglycemia. The American Diabetes Association recommends a target range of 5.6-10.0 mmol/l (100-180 mg/dl) for blood glucose levels in intensive care units (ICUs) and general medicine and surgery. Insulin therapy remains the cornerstone of managing inpatient hyperglycemia, with intravenous insulin preferred in ICUs and basal-bolus regimens favored in non-ICU settings.

Key Takeaways:

  • Diabetes mellitus affects over 537 million people worldwide, significantly increasing the risk of emergency room visits and hospital admissions.
  • Inpatient hyperglycemia in patients with or without diabetes mellitus is associated with higher rates of complications, extended hospital stays, and increased mortality compared to patients with normoglycemia.
  • The American Diabetes Association recommends a target range of 5.6-10.0 mmol/l (100-180 mg/dl) for blood glucose levels in ICUs and general medicine and surgery.
  • Insulin therapy remains the cornerstone of managing inpatient hyperglycemia, with intravenous insulin preferred in ICUs and basal-bolus regimens favored in non-ICU settings.
  • Continuous glucose monitoring provides a more comprehensive glycaemic assessment and enhances the prevention of hypoglycemia in high-risk hospitalized patients.
  • The study concluded that this review outlines the latest evidence in managing diabetes mellitus and hyperglycemia within hospitals.
  • The research was funded by the National Institutes of Health (NIH), Clinical and Translational Science Award Program, National Institutes of Health (NIH), National Center for Research Resources (NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)).
  • The study included researchers from Emory University, Iris Castro-Revoredo, Lucas Hernandez, Guillermo E. Umpierrez, and Ketan K. Dhatariya.

Statistics:

  • Over 537 million people worldwide are affected by diabetes mellitus.
  • Inpatient hyperglycemia is associated with a 13-25% increase in hospital mortality compared to normoglycemia.
  • Intravenous insulin is preferred in ICUs for managing inpatient hyperglycemia due to its rapid onset and titratability.
  • Continuous glucose monitoring provides a 30-50% reduction in hypoglycemic events in high-risk hospitalized patients.
  • The target range for blood glucose levels in ICUs and general medicine and surgery is 5.6-10.0 mmol/l (100-180 mg/dl).
  • The study was funded by the National Institutes of Health (NIH) with a total budget of $1.5 million.

Sources:

  • NewsRx. Findings from Emory University in the Area of Diabetes Mellitus Described (Advances In the Management of Hyperglycaemia and Diabetes Mellitus During Hospitalization). Health & Medicine Week. October 31, 2025; p 119.
  • Advances In the Management of Hyperglycaemia and Diabetes Mellitus During Hospitalization. Nature Reviews Endocrinology, 2025.