Insulin therapy for the management of hyperglycemia in hospitalized patients

Endocrinol Metab Clin North Am. 2012 Mar;41(1):175-201. doi: 10.1016/j.ecl.2012.01.001. Epub 2012 Feb 17.


It has long been established that hyperglycemia with or without a prior diagnosis of diabetes increases both mortality and disease-specific morbidity in hospitalized patients and that goal-directed insulin therapy can improve outcomes. This article reviews the pathophysiology of hyperglycemia during illness, the mechanisms for increased complications and mortality due to hyperglycemia and hypoglycemia, and beneficial mechanistic effects of insulin therapy and provides updated recommendations for the inpatient management of diabetes in the critical care setting and in the general medicine and surgical settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Critical Illness
  • Diabetes Mellitus / drug therapy*
  • Humans
  • Hyperglycemia / drug therapy*
  • Hypoglycemic Agents / therapeutic use*
  • Inpatients
  • Insulin / therapeutic use*


  • Hypoglycemic Agents
  • Insulin