Inpatient diabetes management is challenging for many hospitals and practitioners. Some large academic centers around the United States have specialized diabetes teams, diabetes technology such as continuous glucose monitoring (CGM) and telehealth consultations for inpatient use, and even endocrine hospitalists available to tackle the challenge of inpatient hyperglycemia (1–8). However, most people with diabetes in the United States receive their inpatient care at small community hospitals, where robust (and complex) guidelines and inpatient glycemic protocols may not have significantly changed the culture of glycemic management (9). Some hospital-based practitioners (i.e., hospitalists) practicing within an antiquated culture may rely solely on “sliding-scale” rapid-acting insulin to “correct” high glucose levels, and nurses are desensitized to hyperglycemic events, with a fasting glucose level of, say, 112 mg/dL sometimes being labeled as “low” and prompting a phone call to the provider asking to “hold all insulins.”

The transition...

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