Management of patients with diabetes in hospital

The prevalence of diabetes in the inpatient population is 3–4 times greater than that in the general population. Approximately one in six inpatient beds is occupied by a patient with diabetes. Diabetes is associated with an increased length of stay, increased morbidity and mortality. Patients’ experience of inpatient diabetes care is relatively poor. There is overwhelming evidence that improved glycaemic control reduces morbidity and mortality not only in those with diabetes but also in patients with stress hyperglycaemia. To achieve this often requires the use of insulin but this in itself is associated with significant morbidity and mortality when incorrectly used. All staff involved in managing patient’s glycaemic control should be trained and competent in the use of insulin.