However, oral diabetes medications have important nonglycemic benefits and reduce the risk of widely fluctuating blood glucose levels. Multiple guidelines recommend stopping these medications at admission because of inpatient factors that can increase the risk of renal or hepatic failure. Use of oral diabetes medications, particularly metformin, in hospitalized patients is controversial. The current target is 140 to 180 mg per dL. Previously recommended strict blood glucose targets for hospitalized patients result in more cases of hypoglycemia without improvement in patient outcomes.
Uncontrolled blood glucose levels can lead to deleterious effects on wound healing, increased risk of infection, and delays in surgical procedures or discharge from the hospital. Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens.
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