The American College of Physicians has established guidelines for insulin therapy in hospitalized patients with or without diabetes

• There are no benefits for achieving strict glycemic control rather than less strict control in hospitalized patients.

• It recommends not using intensive insulin therapy (IIT) to strictly control blood glucose or to normalize blood glucose in non-surgical intensive care unit/medical intensive care unit (SICU/MICU) patients with or without diabetes.
• When insulin therapy is used for SICU/MICU patients, the blood glucose level should be kept to 140 to 200 mg/dL, according to the recommendations.
• Evaluation of the benefits and harms of using IIT titrated to strict glycemic targets in hospitalized patients revealed that no consistent evidence of benefit from IIT targeted to strict glycemic control as opposed to less strict control.
• IIT is related to an increased risk of severe hypoglycemia.

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