Table 5.

Summary of Recommendations for the Management of EN-Associated Hyperglycemia

Type of Feeding	ADA’s Standards of Medical Care in Diabetes—2022 (16)	Endocrine Society Clinical Practice Guideline 2012 (1) and 2022 (40)	AACE Guidance on the Management of Inpatient Hyperglycemia in Special Populations (64)	SHM Glycemic Control Implementation Guidelines, 2015 (39)
Continuous TF	NPH insulin every 8 or every 12 hours to cover nutritional needs and basal insulin daily if patient was previously on basal insulin Nutrition needs calculated based on 1 unit of insulin for 10–15 g carbohydrate Correctional RAA insulin every 4 hours or RHI every 6 hours	Glargine/detemir daily or NPH twice daily RAA insulin every 4 hours or RHI every 6 hours Correctional RAA insulin every 4 hours or RHI every 6 hours	NPH or basal insulin once or twice daily (40–50% of TDD) RHI every 6 hours (50–60% of TDD) Correctional RHI every 6 hours	Glargine once daily or detemir twice daily (40–50% of TDD) RAA insulin every 4 hours or RHI every 6 hours (50–60% of TDD) Correctional RAA insulin every 4 hours or RHI every 6 hours
Bolus TF	Continue home basal insulin dose RAA insulin/RHI before each bolus TF based on 1 unit of insulin for 10–15 g carbohydrate Correctional RAA insulin every 4 hours or RHI every 6 hours	RAA insulin or RHI before each bolus TF	RAA insulin or RHI before each bolus TF based on 1 unit of insulin for 10–15 g carbohydrate	Glargine once daily or detemir twice daily RAA insulin before each bolus TF Correctional RAA insulin with each bolus TF
Nocturnal TF	Continue home basal dose Administer NPH at start of the TF	Glargine/detemir for basal coverage NPH insulin plus RAA insulin or RHI at start of the TF Correctional RAA insulin or RHI every 4–6 hours	NPH insulin plus RHI or RAA insulin at the start of the TF RAA insulin or RHI every 4–6 hours Correctional RAA insulin or RHI every 4–6 hours	—