Diabetes mellitus is currently approaching epidemic proportions and disproportionately affects patients in the hospital setting. In the United States, individuals living with diabetes represent over 17 million emergency department visits and 8 million admissions annually. The management of these patients in the hospital setting is complex and differs considerably from the outpatient setting. All patients with hyperglycemia should be screened for diabetes, as in-hospital hyperglycemia portends a greater risk for morbidity, mortality, admission to an intensive care unit, and increased hospital length of stay. However, the definition of hyperglycemia, glycemic targets, and strategies to manage hyperglycemia in the inpatient setting can vary greatly depending on the population considered. Moreover, the presenting illness, changing nutritional status, and concurrent hospital medications often necessitate thoughtful consideration to adjustments of home diabetes regimens and/or the initiation of new insulin doses. This review article will examine core concepts and emerging new literature surrounding inpatient diabetes management, including glycemic targets, insulin dosing strategies, noninsulin medications, new diabetes technologies, inpatient diabetes management teams, and discharge planning strategies, to optimize patient safety and satisfaction, clinical outcomes, and even hospital financial health.

中文翻译：

---

住院糖尿病管理


糖尿病目前正接近流行病的程度，并且对医院环境中的患者造成不成比例的影响。在美国，每年有超过 1700 万名糖尿病患者到急诊室就诊，并有 800 万人入院。这些患者在医院环境中的管理很复杂，并且与门诊环境有很大不同。所有高血糖患者都应接受糖尿病筛查，因为院内高血糖预示着发病率、死亡率、入住重症监护室以及住院时间增加的更大风险。然而，住院患者中高血糖的定义、血糖目标和管理高血糖的策略可能因所考虑的人群而有很大差异。此外，目前的疾病、营养状况的变化以及同时住院的药物通常需要仔细考虑调整家庭糖尿病治疗方案和/或开始新的胰岛素剂量。本文将探讨围绕住院糖尿病管理的核心概念和新兴文献，包括血糖目标、胰岛素剂量策略、非胰岛素药物、新糖尿病技术、住院糖尿病管理团队和出院计划策略，以优化患者安全和满意度、临床结果，甚至医院财务健康状况。