Hyperglycemia Management in the Hospital: The Pharmacists Role

Hyperglycemia is prevalent in the inpatient setting and is associated with increased morbidity and mortality in patients with diabetes and in those without diabetes. Too often hyperglycemia is underrecognized, under-reported, and undermanaged. Insulin is the treatment of choice for most patients who have hyperglycemia and are hospitalized, and pharmacists are often responsible for ensuring its safe and effective use. Improving hyperglycemia management in patients who are hospitalized provides pharmacists with an opportunity to positively affect patient outcomes and health care costs. This article discusses the pharmacist's role in managing blood glucose levels; current recommendations for target blood glucose concentrations; the evolution of insulin treatment from sliding scale to algorithms/protocols to computer-guided decision-support systems; discharge planning; and patient education.