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Am Fam Physician. 2023;108(3):313-314

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Key Points for Practice

• Although insulin has the best evidence for maintaining glycemic control in hospitalized patients, dipeptidyl-peptidase-4 inhibitors may be equivalent for patients with type 2 diabetes.

• Corrective insulin alone only slightly increases average blood glucose levels vs. basal-bolus insulin and may reduce the risk of hypoglycemia.

• Carbohydrate counting has minimal impact on glycemic control compared with fixed mealtime insulin dosing.

• Diabetes education during hospitalization can improve outpatient glycemic control and reduce readmissions.

From the AFP Editors

One-fourth of hospitalized patients have diabetes mellitus, and up to one-third of those without diabetes experience glucose levels greater than 140 mg per dL (7.77 mmol per L) during their hospital stay. Diabetes and hyperglycemia are associated with prolonged hospitalizations. The Endocrine Society released updated guidelines for glycemic management during hospitalization with noncritical illnesses.

Monitoring Hospitalized Patients

For patients without diabetes and those with diabetes controlled without insulin, point-of-care blood glucose testing is recommended.

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Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Michael J. Arnold, MD, associate medical editor.

A collection of Practice Guidelines published in AFP is available at https://www.aafp.org/afp/practguide.

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