Table 7.

Glycemic management in patients with acute febrile illness (AFI)

Adapted from [134]

	Glycemic management
AFI patients with adequate oral intake	Frequent BGM to check for hyperglycemic episodes Continue OADs in patients eating well if BG is well controlled and no contraindication with OADs Initiate insulin If BG is poorly controlled with OADs
AFI patients with compromised oral intake	Modification in diet (small portion sizes, at frequent intervals)
AFI patients on concomitant corticosteroid therapy	In steroid-induced or worsened hyperglycemia, subcutaneous insulin using a basal or multiple daily injections regimen
AFI patients with compromised hepatorenal function	Rapid-acting insulin in small, frequent doses to manage hyperglycemia
AFI patients with compromised sensorium	Discontinue OADs and initiate IV insulin Alternatively, SC rapid-acting insulin may be used
AFI in elderly patients	Frequent BGM to detect atypical symptoms of hyperglycemia and hypoglycemia
AFI patients with cachexia/asthenia	An insulin regimen which provides both prandial and basal coverage, such as premixed/dual action or basal plus/basal-bolus insulin in patients with lack of energy (asthenia), with or without wasting, loss of weight, muscle atrophy, fatigue, and loss of appetite (cachexia) during the febrile or convalescence phase

OAD oral antihyperglycemic drugs, BGM blood glucose monitoring, AFI acute febrile illness, IV intravenous, IM intramuscular, SC subcutaneous