Management of Inpatient Hyperglycemia and Diabetes in Older Adults

Clin Geriatr Med. 2020 Aug;36(3):491-511. doi: 10.1016/j.cger.2020.04.008. Epub 2020 Apr 18.


Diabetes is one of the world's fastest growing health challenges. Insulin therapy remains a useful regimen for many elderly patients, such as those with moderate to severe hyperglycemia, type 1 diabetes, hyperglycemic emergencies, and those who fail to maintain glucose control on non-insulin agents alone. Recent clinical trials have shown that several non-insulin agents as monotherapy, or in combination with low doses of basal insulin, have comparable efficacy and potential safety advantages to complex insulin therapy regimens. Determining the most appropriate diabetes management plan for older hospitalized patients requires consideration of many factors to prevent poor outcomes related to dysglycemia.

Keywords: Diabetes; Elderly; Hospitalized; Hyperglycemia; Incretin; Inpatient; Insulin; Older adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / drug effects*
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / drug therapy*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Inpatients*
  • Insulin / adverse effects
  • Insulin / therapeutic use*
  • Male


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin