Background: Glucose management of hospitalized patients with hyperglycemia has many challenges. One of these challenges is the timing of insulin administration in coordination with meal delivery. The Endocrine Society recommends assessing glucose levels within 60 minutes of prandial insulin administration and that rapid-acting insulin should be administered 15 minutes before or immediately after a meal.1 [...]

Background: Insulin is the preferred agent to manage hyperglycemia in the hospital. However, it is considered a high alert medication due to risk of hypoglycemia and severity of adverse events. In our institution, three hospitals currently use an order for correctional insulin based on a formula, in which the nurse calculates the dosage using the [...]

Background: Diabetes is common, present in up to one third of hospitalized patients and up to 50% of critically ill patients. Studies have shown that hyperglycemia among hospitalized patients leads to worse clinical outcomes and increases readmission rates by over 30% relative to normo-glycemic patients. Insulin is the only medication recommended for treatment of diabetes [...]