Summary

• Patients with newly discovered hyperglycaemia have significantly higher in-hospital mortality than patients with a known history of diabetes or normoglycaemic patients.
• Increasing evidence indicates that the development of hyperglycaemia during acute medical or surgical illness is not a physiological or benign condition, but is a marker of poor clinical outcome and mortality.
• Both hyperglycaemia and hypoglycaemia are associated with higher mortality, independent of known history of diabetes.
• Effective management of hyperglycaemia is associated with a decreased length of ICU and hospital stay. Tight glycaemic control in the normal range of 4.4 mmol/L to 6.1 mmol/L (80-110 mg/dL) may not be necessary, however, and may be harmful.
• Basal-bolus insulin regimen has been shown to be more effective than sliding scale insulin alone in patients admitted to hospital who are not critically ill.