Protocol for Diabetes Management in hospital – 2020

It is estimated that one-third of Hospitalized patients experience significant hyperglycaemia and most are admitted for reasons other than Diabetes. Good Diabetes control in hospitalized patients irrespective of reason for admission improves mortality, morbidity and overall cost of hospital stay.  It prevents complications and helps to educate the future follow-ups and management.

Insulin is the drug of choice in all hospitalized patients. Patients who are on oral agents needs to be stopped as the dose cannot be titrated and some medications can cause acidity and few may cause hypoglycaemia, weight gain etc.

Insulin regimens are categorized according to the patients’ condition and circumstances such as patients in intensive care unit, in medical & surgical wards, on enteral/tube feedings, who are kept nil orally or who are on steroids. Insulin dose requirement may be thought of as consisting “basal” and “nutritional” insulin requirement.

During hospitalisation in addition to the basal & nutritional, the requirement may increase due to stress, infection & various medications. This we tell “correction” dose.

The target glycaemic control for ICU patients should be between 140 -180mg/dl for more tighter control can cause hypoglycaemia and increased mortality. 

For non-critically ill patients who are eating pre-meals between 80 – 140mg and after food between 140-180mg/dl.

This proforma is prepared for practising doctors for better understanding and treatment of Diabetes in Hospital.

In-Hosp-Diabetes-Proforma-2020-Shortcut

You can download the above form here.