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Newswise — LOS ANGELES (March 19, 2025) -- When patients who have diabetes are hospitalized, they face a greater risk of complications, infections and hospital readmission than other patients.

“Patients are not usually hospitalized because of diabetes, but because of another condition, so they are not admitted in one specific area of the hospital,” said , medical director of Diabetes Quality and vice chair of Quality and Innovation at Cedars-Sinai. “It’s important that specialized protocols and programs that prioritize diabetes care are available hospital-wide.”

Diabetes affects how the body turns food into energy, sometimes causing high blood sugar, also known as high blood glucose or hyperglycemia. Hospitalized patients who do not have diabetes also can develop high blood glucose—a condition called stress hyperglycemia—which can lead to poor outcomes.

Gianchandani, an endocrinologist, along with Cedars-Sinai Fellow Margaret Wei, MD, authored a paper published in Annals of Internal Medicine about hospital best practices for managing high blood glucose. Gianchandani leads the medical center’s interdisciplinary efforts to improve outcomes for hospitalized patients with diabetes or stress hyperglycemia.

The Cedars-Sinai Newsroom spoke with Gianchandani about these efforts.

What does inpatient diabetes management involve?

Hospitals should use diabetes experts to help patients reach their safest blood sugar levels, which is shown to shorten hospital stays and improve outcomes. There is no single best diabetes team format—institutions should do what works with their own processes—but the most effective teams use experts to manage a patient from admission to discharge and conduct post-discharge follow-ups.

At Cedars-Sinai, we have a heterogeneous team format that includes endocrinologists (faculty and private), endocrinology trainees, diabetes educators, pharmacists and information technologists with a focus on hospital diabetes management. We also are increasingly integrating diabetes technology into our medical ordering system to help non-diabetes practitioners better manage their patients. Our diabetes clinicians are familiar with the latest diabetes technologies and increasingly used devices like continuous glucose monitors.

What’s new about Cedars-Sinai’s approach to inpatient diabetes care?

Collectively, our teams have prioritized several key components that have been shown to improve outcomes. We have standardized care by creating nursing policies for monitoring blood sugar and administering insulin, as well as procedures for addressing low blood sugar.

We are at the forefront of technology integration. We are using a computerized tool to support nurses administering insulin through an IV—the nurse simply enters the patient’s blood sugar, and the tool calculates how much insulin to give without the nurse needing to make that complex calculation. We also have insulin pumps and glucose sensors integrated into the patient’s electronic medical record, so we can monitor patients’ blood sugar as needed after they go home. This would allow us in the future to follow up if the patient needed to adjust their insulin dosage.

I am proud to share that Cedars-Sinai also has a pharmacist surveillance program. A pharmacist reviews abnormally high and low blood sugar levels every morning and reaches out to patients’ physicians if medication orders need to be adjusted.

We also are evaluating predictive algorithms using artificial intelligence tools for managing diabetes. For example, monitoring patients over time, an algorithm could predict when their blood sugar might go too high or too low.

How does Cedars-Sinai educate diabetes patients in the hospital?

A hospital stay provides a unique opportunity for diabetes education. We have several educators in the hospital as well as outpatient educators. Our inpatient educators interact with patients during admission to address any gaps in care they may be experiencing, and they strive to ensure patients go home with the resources they need to maintain safe blood sugar levels.

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