Hospital Management of Diabetes

Diabetes remains a major cause of death and disability and is a growing global concern. The age-adjusted prevalence of type 2 diabetes in the United States increased by more than 55 % from 1990 to 2000 [1]. It is estimated that one out of three individuals born in 2000 will develop diabetes in their lifetime [2]. Chronic complications of diabetes, especially cardiovascular disease, result in hospitalization in many patients with diabetes. In 2001, more than 4.6 million hospitalizations were associated with diabetes, accounting for nearly 17 million hospital days at a cost of over $40 billion [3]. Mounting observational and interventional evidence consistently indi-cates that hyperglycemia in the hospital setting is associated with increased mortality and morbidity and that meticulous glycemic control can improve clinical outcomes [4–7]. The purpose of this article is to review the evidence, discuss the importance of striving for good glycemic control in the hospital setting, and emphasize the need for additional outcome research studies to further examine the currently recommended in-hospital glycemic guidelines