5.0.0.0 An­ti­hy­per­glycemic Agents in Hosp. Pts.

5.1.0.0 Rec­om­men­da­tions

Rec­om­men­da­tions

15.6 Basal in­sulin or a basal plus bolus cor­rection in­sulin reg­i­men is the pre­ferred treat­ment for noncrit­i­cal­ly ill hos­pi­talized pa­tients with poor oral in­take or those who are tak­ing noth­ing by mouth. An in­sulin reg­i­men with basal, pran­di­al, and cor­rection com­po­nents is the pre­ferred treat­ment for noncrit­i­cal­ly ill hos­pi­talized pa­tients with good nu­tri­tion­al in­take. A

15.7 Sole use of slid­ing scale in­sulin in the in­pa­tient hos­pi­tal set­ting is strong­ly dis­cour­aged. A

In most in­stances in the hos­pi­tal set­ting, in­sulin is the pre­ferred treat­ment for hy­per­glycemia (2). How­ev­er, in cer­tain cir­cum­stances, it may be ap­pro­pri­ate to con­tin­ue home reg­i­mens in­clud­ing oral an­ti­hy­per­glycemic med­i­ca­tions (32). If oral med­i­ca­tions are held in the hos­pi­tal, there should be a pro­to­col for re­sum­ing them 1–2 days be­fore dis­charge. In­sulin pens are the sub­ject of an FDA warn­ing be­cause of po­ten­tial blood-‍borne dis­eases, and care should be taken to fol­low the label in­sert “For sin­gle pa­tient use only” (33). Re­cent re­ports, how­ev­er, have in­di­cat­ed that the in­pa­tient use of in­sulin pens ap­pears to be safe and may be as­so­ci­at­ed with im­proved nurse satisfac­tion com­pared with the use of in­sulin vials and sy­ringes (34-36).