Hospitalized patients with diabetes need a different approach than they get in the clinic. This course covers the diagnosis and management of diabetes and glycemic disorders in the hospital, from the emergency room through admission, critical illness, surgery, and discharge home.
Across 15 topics, you’ll learn to set inpatient glucose targets, build and adjust basal/bolus insulin regimens, manage DKA, HHS, and hypoglycemia, and handle situations like steroids, tube feeds, surgery, and insulin pumps. You’ll also learn to plan safe transitions from hospital to home. Applied case scenarios throughout the course help you put these skills into practice at the bedside.
Course Faculty
- Rifka Schulman-Rosenbaum, MD, FACE, FACP: Associate Chief of Endocrinology, Northwell Health; Director of Inpatient Diabetes, Long Island Jewish Medical Center; Professor of Medicine, Zucker School of Medicine
- Andrew Demidowich, MD: Associate Professor of Clinical Medicine; Chair, JHM Council for Clinical Excellence in Inpatient Diabetes; Chief, Inpatient Endocrinology, Howard County Medical Center, Johns Hopkins Medicine
Course Outline
- General Inpatient Glucose Management: Goals & Targets: How hyperglycemia affects outcomes, inpatient glucose goals, monitoring, and which diabetes medications to use or stop in the hospital.
- The Basics of Basal/Bolus Insulin in the Inpatient Setting: Four ways to calculate a total daily dose, correction scales, and how to adjust the regimen, with worked examples.
- Conversion Between Insulin Products (Hospital Formulary): Basal, bolus, premixed, and U-500 conversions from outpatient to inpatient and back again.
- Management of Once-Weekly Insulin in the Inpatient Setting: Converting once-weekly insulins to inpatient regimens and back at discharge.
- Diabetes-Related Ketoacidosis (DKA) & Hyperosmolar Hyperglycemic State (HHS): The updated 2024 diagnostic criteria, fluids, insulin, electrolytes, euglycemic DKA, and the transition from IV to subcutaneous insulin.
- Hypoglycemia Crises: Recognizing, treating, and preventing hypoglycemia, including NPO patients and interrupted nutrition.
- Inpatient Hyperglycemia Management: Common & Special Situations: Troubleshooting persistent hyperglycemia, NPO status, enteral and parenteral nutrition, kidney disease, gastroparesis, and insulin allergy.
- Diabetes Management During Steroid-Induced Hyperglycemia: Insulin strategies matched to the type of glucocorticoid, planning for the taper, and discharge.
- Inpatient Use of Diabetes Technology: Deciding when to continue or stop an insulin pump, and using CGM in the hospital.
- Perioperative & Postoperative Diabetes Management: Glucose targets, choosing the insulin route, type 1 considerations, and holding SGLT2 inhibitors and GLP-1 receptor agonists.
- Newly Diagnosed Type 1 Diabetes: Patient Education & Survival Skills: Diagnosis, LADA, carbohydrate counting, and sick day rules.
- Newly Diagnosed Type 2 Diabetes: Treatment Selection & Patient Education: Choosing medications based on A1C and other conditions, plus survival skills education.
- Transitions of Care: Hospital to Home: Discharge planning, avoiding medication mishaps, and helping uninsured or underinsured patients.
- Management of Diabetes from the Emergency Room: Triage, giving insulin on time, and managing patients who go home from the ER versus those who are admitted.
- Inpatient Diabetes Quality Measures & eCQM: Quality metrics, readmission drivers, effects on hospital finances, and practical quality improvement projects.
