A new Clinical Practice Guideline (CPG) from the American College of Endocrinology recommends that hospitals implement glucose testing for all inpatients and notes that optimizing the management of patients with hyperglycemia is not a need for deep care. The guideline was published in the January 2012 issue of the Journal of Clinical Endocrinology and Metabolism (J Clin Endocrinol Metabol). ”Hyperglycemia is associated with longer hospital stays, increased incidence of infection and death in non-critical inpatients,” noted CPG expert panel chair Guillermo Umpierrez, MD, from Emory University in Atlanta, Ga. “This new edition of the guidelines synthesizes the consensus recommendations of experts in the field of hyperglycemia management in hospitalized patients in non-critical care conditions.” Previous observational studies have shown that hyperglycemia affects 32% to 38% of community hospital patients and is not limited to individuals with a history of diabetes. Observational studies and randomized controlled trials have shown that better glycemic control in general medical and surgically treated patients is associated with fewer in-hospital complications. In addition, the guidelines set glycemic attainment values and describe methods and system improvements to assist in achieving glycemic attainment. Key points of the guideline recommendations are as follows: 1. All patients, regardless of a pre-existing diagnosis of diabetes, should have laboratory glucose testing on admission. If this test has not been performed in the last 2 or 3 months, patients hospitalized with known diabetes or hyperglycemia (blood glucose > 7.8 mmol/L) should have their glycated hemoglobin levels tested. 2. For most hospitalized non-serious patients, the target value for pre-meal glucose is less than 140 mg/dl and the target for random glucose measurement level is less than 180 mg/dl. If the glucose level is less than 5.6 mmol/L (100 mg/dl), the antidiabetic treatment should be re-evaluated; if the glucose level is less than 3.9 mmol/L (70 mg/dl), the antidiabetic treatment plan should be modified. 3. The target value of blood glucose should be adjusted according to the clinical status. Patients who are not prone to hypoglycemia should have their blood glucose more tightly controlled; for patients with end-stage disease, limited life expectancy or high risk of hypoglycemia, the target value range should be increased (<11.1 mmol/L or 200 mg/dl). 4. Patients with diabetes who receive insulin therapy at home should receive a scheduled regimen of subcutaneous insulin injections at the time of their hospitalization. 5. To prevent perioperative hyperglycemia, all patients with type 1 diabetes and most patients with type 2 diabetes who undergo surgery should receive intravenous continuous insulin infusion or subcutaneous basal insulin injection therapy (with insulin pump if needed). 6. All patients with high blood glucose values on admission (> 7.8 mmol / L, i.e., 140 mg/dl) and all patients receiving enteral or parenteral nutrition, regardless of history of diabetes, should have immediate bedside monitoring of blood glucose. This recommendation also applies to patients receiving hyperglycemia-related therapy (e.g., glucocorticoids or octreotide). 7. At least 1 to 2 hours before interruption of continuous intravenous insulin infusion therapy, all patients with type 1 and type 2 diabetes should be switched to scheduled subcutaneous insulin therapy.