TABLE 1

Major guidelines for treatment of hyperglycemia in a hospital setting

Organization	Intensive care unit	Non-intensive care unit
American Diabetes Association/American Association of Endocrinologists¹³	Initiate insulin therapy for persistent hyperglycemia (glucose > 180 mg/dL [10 mmol/L]). Treatment goal: For most patients, target a glucose level between 140 and 180 mg/dL. More stringent goals (110–140 mg/dL) may be appropriate for select patients, if achievable without significant risk of hypoglycemia.	No specific guidelines. If treated with insulin, premeal glucose targets should generally be < 140 mg/dL, with random glucose levels < 180 mg/dL.
American College of Physicians⁴⁶	Recommends against intensive insulin therapy in patients with or without diabetes in surgical or medical intensive care. Treatment goal: Target glucose level is between 140 and 200 mg/dL in patients with or without diabetes in surgical or medical intensive care.
Critical Care Society²⁹	Glucose level > 150 mg/dL should trigger insulin therapy. Treatment goal: Maintain glucose level < 150 mg/dL for most adult patients in intensive care. Maintain glucose level < 180 mg/dL while avoiding hypoglycemia.
Endocrine Society²⁶		Premeal glucose target < 140 mg/dL. Random glucose < 180 mg/dL. A lower target range may be appropriate in patients able to achieve and maintain glycemic control without hypoglycemia. Glucose < 180–200 mg/dL is appropriate in patients with terminal illness or with limited life expectancy or at high risk for hypoglycemia. Adjust antidiabetic therapy when glucose falls < 100 mg/dL to avoid hypoglycemia.
Society of Thoracic Surgeons²⁸	Guidelines specific to adult cardiac surgery. Continuous insulin infusion preferred over subcutaneous or intermittent intravenous boluses. Treatment goal: Recommend glucose < 180 mg/dL during surgery (≤ 110 mg/dL in fasting and premeal states).
Joint British Diabetes Societies²⁷		Target glucose levels in most patients are between 6 and 10 mmol/L (108–180 mg/dL) with an acceptable range of between 4 and 12 mmol/L (72–216 mg/dL).