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Chapter 5
Food, Fasting, Insulin, and Glycemic Control in the Hospital
Mary Korytkowski, MD,1 Boris Draznin, MD, PhD,2 and Andjela Drincic, MD3
1Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA. 2Division of Endocrinology, Diabetes, and Metabolism, University of Colorado School of Medicine, Aurora, CO. 3Division of Diabetes, Endocrinology and Metabolism, Medical Director, The Nebraska Medical Center Diabetes Center, Omaha, NE.
DOI: 10.2337/9781580406086.05
Introduction
Diabetes treatment in the hospital poses unique challenges that differ from those encountered in the outpatient setting.1–5 These challenges arise from patient factors that include illness-related variability in insulin sensitivity, as well as system factors related to inconsistency in hospital procedures for insulin dosing and meal delivery, complicating the ability to achieve and maintain desired glycemic goals.3–7 Despite the demonstrated superiority of scheduled insulin therapy over sliding-scale insulin (SSI) regimens, the latter persists as a fallback strategy for many
