ADA Guidelines For Hospital Admission of Diabetic Patients

Uncontrolled Diabetes

Poor metabolic control of established diabetes as defined herein justifies admission if it is necessary to determine the reason for the control problems and to initiate corrective action. For admission under these guidelines, documentation should include at least one of the following:

  • Hyperglycemia associated with volume depletion.
  • Persistent refractory hyperglycemia associated with metabolic deterioration.
  • Recurring fasting hyperglycemia >300 mg/dl (>16.7 mmol/l) that is refractory to outpatient therapy or a glycated hemoglobin level of 100% above the upper limit of normal.
  • Recurring episodes of severe hypoglycemia (i.e., <50 mg/dl [<2.8 mmol/l]) despite intervention.
  • Metabolic instability manifested by frequent swings between hypoglycemia (<50 mg/dl [<2.8 mmol/l]) and fasting hyperglycemia (>300 mg/dl [>16.7 mmol/l]).
  • Recurring diabetic ketoacidosis without precipitating infection or trauma.
  • Repeated absence from school or work due to severe psychosocial problems that cannot be managed on an outpatient basis. Diabetes Care 22(1):s80, 1999

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