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Table 1 Approach to glycemic control in various blood glucose ranges

From: Screening and management of hospital hyperglycemia in non-critical patients: a position statement from the Brazilian Diabetes Society (SBD)

Randomly discovered blood glucose in hospitalized patient

Action

Blood Glucose Level <140 mg/dL in Patients without Diabetes or Risk Factors for Stress Hyperglycemia (The specific risk factors are detailed in the footnote)

No need for follow-up

140–180 mg/dL

or

presence of Risk Factors*

(The specific risk factors are detailed in the footnote)

• Capillary Blood Glucose Monitoring (CBGM)

• Preprandial Correction Insulin for Occasional Hyperglycemia—Tables 2 and 4 (Less than one episode per day above 180 mg/dL and all below 250 mg/dL)

180–200 mg/dL

AND

No outpatient use of insulin

• CBGM

• Basal Insulin Therapy Combined with Preprandial Corrections—Tables 2 and 4; or

• DPP-4 Inhibitors Associated with Preprandial Corrections;

200–250 mg/dL

or

Outpatient use of insulin with a total dose below 0.6 IU/kg

• CBGM

• Basal Insulin Therapy Combined with Preprandial Corrections—Tables Table 2 and 4

>250 mg/dL,

or

History of type 1 diabetes, LADA, Secondary diabetes due to Pancreatectomy,

or

Outpatient use of Insulin with a total dose above 0.6 IU/kg

• CBGM

• Basal-Bolus Insulin Therapy

Hyperglycemia Secondary to Glucocorticoids Use

• Basal-Bolus Insulin Therapy with/or NPH Insulin in the Morning, Proportional to the Glucocorticoid Dose

  1. *RISK FACTORS
  2. Use of glucocorticoids, Post-organ transplantation, Postoperative period (24–48 h), Enteral or parenteral nutrition, Fasting state, Use of glucose-containing solutions, Systemic inflammatory response syndrome (SIRS), Sepsis, Arterial hypertension, Dyslipidemia, Obesity, Previous history of hospital hyperglycemia or diabetes mellitus