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Inpatient Management of Adults with Diabetes

H capitalization is more common for people with diabetes than for those without diabetes. In addition, patients with diabetes are more likely to be hospitalized for a longer period of time than those without diabetes. In one report, people with diabetes were hospitalized 2.4 times more frequently than people without diabetes and stayed in the hospital for a longer (30% longer) amount of time (1). In 1992, there were a total of 371,969 hospitalizations accounting for 2.3 million hospital days attributable to diabetes (2). Not surprisingly, most of these hospitalizations are directly due to the complications of the disease, mostly those related to the circulatory system (2,3). In 1987, diabetic complications accounted for 2% of total hospital admissions in the U.S. (3). Because the prevalence of diabetes may be increasing in the U.S. (4), it is likely that an even greater number of patients with diabetes will be admitted to our hospitals in the years to come. Recently, a plethora of reports have been published reviewing outpatient diabetes therapy for both insulindependent diabetes mellitus (IDDM) (516) and non-insulin-dependent diabetes mellitus (NIDDM) (10,17-24). In addition, there is a large body of literature that reviews inpatient therapy as it pertains to perioperative diabetes management. However, there is no major review that examines inpatient diabetes therapy as it relates to the nonsurgical situation. Because of the lack of studies examining this issue and the importance and increasing frequency of hospitalizations for patients with diabetes, it seems appropriate to review this subject.