Initiating Insulin Therapy in Hospitalized Patients

Dr. Nadine Palermo, an endocrinologist and the Associate Director of the Acute Diabetes Care program at Brigham and Women’s Hospital, talks with Joyce Zhou (host) and Jakub Glowala (case presenter) to discuss the management of inpatient diabetes patients. Dr. Palermo begins by discussing the way to think about hyperglycemic patients in the hospital, how we can arrive at new diagnoses of diabetes, in addition to why treating inpatient dysglycemia matters. Dr. Palermo provides us with a brief detour on non-insulin agents, their associated side effects, and their potential use in particular hospitalized patients in the future. We are then taught about using a weight-based approach to hyperglycemic management, taking into consideration other comorbidities and feeding requirements, as well given an understanding of the various insulin agents (rapid-, intermediate-, and long-acting), in order to establish an individualized plan for the inpatient hyperglycemic patient.