Target Blood Glucose to Maintain

Hospitalized Patients

The American Diabetes Association recommends initiating insulin therapy when blood glucose persistently exceeds 180 mg/dL, with a target range of 140-180 mg/dL for both critically ill and non-critically ill patients 1, 2
For critically ill patients, the target range is 140-180 mg/dL, and more stringent targets of 110-140 mg/dL may be considered for select patients, such as those post-cardiac surgery, only if achievable without significant hypoglycemia 1, 2
The American College of Critical Care Medicine recommends avoiding targets <110 mg/dL, as the NICE-SUGAR trial demonstrated that intensive glucose control targeting 81-108 mg/dL increased mortality by 2% compared to targets of 140-180 mg/dL 1, 3
For non-critically ill hospitalized patients, the target range is 100-180 mg/dL, with premeal glucose targets <140 mg/dL and random blood glucose <180 mg/dL 1, 2, 4

The American Diabetes Association recommends preprandial glucose targets of 80-130 mg/dL and postprandial glucose targets <180 mg/dL for most non-pregnant adults with diabetes 5
The American Association of Clinical Endocrinologists recommends individualized targets based on patient factors, such as newly diagnosed diabetes, long life expectancy, and absent or minimal comorbidities, with more stringent goals of 70-120 mg/dL fasting 5, 7

The Society of Critical Care Medicine recommends never targeting glucose <110 mg/dL in critically ill patients, as this increases mortality risk by 10-15 fold rates of hypoglycemia 1, 3
The American Diabetes Association recommends minimizing glycemic variability, as wide glucose swings are associated with higher mortality independent of mean glucose levels 3

The American College of Physicians recommends determining patient category, such as critically ill ICU patient, non-critically ill hospitalized, or outpatient with diabetes, to guide insulin therapy and glucose targets 1, 2, 4, 5
The Endocrine Society recommends initiating insulin therapy when glucose ≥180 mg/dL on two occasions for hospitalized patients, and using intravenous insulin for critically ill patients and subcutaneous basal-bolus regimens for non-critically ill patients 1, 2, 4