Standards of Care (ADA 2024/2025)
The annual screening requirement for patients on long-term Metformin therapy to check for this specific vitamin deficiency.
What is Vitamin B12?
This medication is the only type of insulin that can be administered intravenously.
What is Regular Insulin?
The leading cause of death in patients with T2D, accounting for roughly 75% of mortality.
What is Cardiovascular Disease?
This oral class is generally avoided in the hospital due to the high risk of prolonged hypoglycemia, especially in elderly patients or those with erratic meal trays.
What are Sulfonylureas?
This class of oral antihyperglycemic agents must be held 3-4 days prior to surgery due to the risk of euglycemic DKA.
What are SGLT2 inhibitors?
This is the recommended A1C goal for most non-pregnant adults, though it can be loosened to <8% for those with limited life expectancy or advanced complications.
This triple agonist (targeting GLP-1, GIP, and Glucagon receptors) is currently generating significant buzz in clinical trials.
What is Retatrutide?
This physical exam finding, described as "spongy swelling" at injection sites, indicates the need to rotate insulin administration areas.
What is hypertrophic lipodystrophy?
Use of this drug class is contraindicated in patients hospitalized for acute Heart Failure (NYHA Class III/IV) due to risks of fluid retention.
What are Thiazolidinediones/TZDs?
On the morning of surgery, patients with T1D or insulin-dependent T2D should typically receive this percentage of their normal NPH or long-acting basal dose.
What is 75-80%?
The new 2025 ADA recommendation for the A1C goal in children and adolescents with T2D who have low hypoglycemia risk.
What is <6.5%?
This long-acting basal insulin should never be mixed with other insulins in the same syringe due to its low pH.
What is Glargine?
The three "priority interventions" for a patient presenting in DKA.
What are IV fluids, IV short-acting insulin, and electrolyte replacement?
This medication should be held for 48 hours following any procedure involving iodinated contrast to prevent lactic acidosis in the setting of potential AKI.
What is Metformin?
For patients receiving high-dose glucocorticoids, the hospitalist should expect a disproportionate rise in this type of glucose reading.
What is post-prandial or afternoon-evening glucose?
For patients with established ASCVD or high cardiovascular risk, these two drug classes should be prioritized independent of A1C.
What are GLP-1 RAs and SGLT2i?
The drug class that should be temporarily discontinued during "sick days" to reduce the risk of euglycemic DKA.
What are SGLT2 inhibitors?
The approach for managing mild hypoglycemia in the clinic setting, involving intake of rapid-acting carbohydrates and monitoring.
In patients with severe gastroparesis or bowel obstruction, this class of injectable non-insulin meds should be discontinued.
What are GLP-1 Receptor Agonists?
When managing a patient on Continuous Enteral Nutrition, this type of insulin is often preferred as the "basal" component to match the delivery of the formula.
What is NPH or Regular insulin?
The screening frequency recommended for "diabetes distress" in both patients and their caregivers.
What is at least annually?
The specific hormone, alongside insulin, produced by pancreatic beta cells; a long-acting analogue of this is now used in therapy.
What is Amylin?
This condition, often presenting with burning or "walking on pillows" sensations, is a common indication for Gabapentin or Pregabalin.
What is peripheral neuropathy?
This specific DPP-4 inhibitor is the only one in its class that does not require renal dose adjustment.
What is Linagliptin/Tradjenta?
What is undetected hypoglycemia?