Interactive diabetes case 1: Inpatient management in type 1 diabetes – A3

ANSWER — Not indicated.

While the fasting glucose level of 101 mg/dL (5.6 mmol/L) is below the target range for premeal blood glucose values of 140 to 180 mg/dL (7.8 to 10 mmol/L) for most hospitalized patients with diabetes, except those who are acutely ill, it is not in the hypoglycemic range. It's not broken, so don't fix it.

Reassessment of the insulin regimen should be considered when blood glucose values fall below 100 mg/dL (5.6 mmol/L). Modification of pharmacologic treatment is usually indicated when blood glucose values are below 70 mg/dL (3.9 mmol/L).

The reader is urged to return to the case at the beginning of this sequence in order to explore the consequences of the alternate choices. (See "Interactive diabetes case 1: Inpatient management in type 1 diabetes".)