What is a typical hospital management strategy for non-ICU diabetic patients with hyperglycemia?

• A. Regular insulin sliding scale with basal-bolus if needed; target 140-180 mg/dL; monitor.
• B. Continuous IV insulin infusion without monitoring.
• C. Initiate metformin only.
• D. No insulin unless glucose exceeds 400 mg/dL.

Answer: (A)

In non-ICU inpatients, the goal is to keep blood glucose in a safe, steady range by mimicking normal insulin patterns: a basal insulin to provide ongoing coverage and rapid-acting (bolus) insulin around meals to handle post-meal spikes, with adjustments as needed. The typical target range for most non-critically ill patients is about 140–180 mg/dL, which balances the risks of hyperglycemia with the danger of hypoglycemia during illness. Relying on an IV insulin drip without monitoring is reserved for ICU-level care; starting metformin alone isn’t appropriate in acute illness due to potential kidney issues and lactic acidosis risk; and waiting for glucose to exceed 400 mg/dL before starting insulin would let hyperglycemia go untreated. A plan that uses sliding-scale insulin in combination with basal-bolus coverage and careful monitoring provides steady control and the ability to correct highs without excessive fluctuations.