Strategies for Insulin Therapy
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The majority of patients who have hyperglycemia in the hospital should be treated with subcutaneous insulin. In the ICU setting, insulin infusion is often the route of administration of choice. Special circumstances in hospital insulin management that often pose a challenge for the clinician include patients who are not eating, perioperative and periprocedural management, patients who are receiving enteral tube feeding or total parenteral nutrition, and those who are treated with high-dose glucocorticoid therapy. Practical guidelines for the administration of insulin in these various hospital settings are provided in
Table 2. Practical Guidelines for Hospital Use of Insulin.
