RSSDI clinical practice guidelines for the management of hyperglycemia in hospitalized patients (2025)

In-hospital hyperglycemia, including diabetes-related and stress-induced hyperglycemia, is common and associated with adverse clinical outcomes. Standardized, context-specific inpatient glycemic management strategies are required across Indian healthcare settings.

To develop India-specific, evidence-informed clinical practice guidelines for safe and effective management of hyperglycemia in hospitalized patients.

The RSSDI Clinical Practice Guidelines for the Management of Hyperglycemia in Hospitalized Patients (2025) were developed by a multidisciplinary panel under the RSSDI Scientific Committee. Recommendations build upon prior RSSDI guidance, national consensus statements on inpatient glucose monitoring and time-in-range metrics, and contemporary international standards. Evidence was appraised and adapted to Indian clinical practice, accounting for variability in resources and infrastructure. Iterative expert review informed final consensus recommendations.

The guidelines address definitions of in-hospital hyperglycemia, glycemic targets in critically and non-critically ill patients, glucose monitoring strategies, role of continuous glucose monitoring, insulin infusion protocols in intensive care, basal–bolus and correctional insulin regimens in non-critical care, transition from intravenous to subcutaneous insulin, and management in perioperative, glucocorticoid-associated, and nutrition-related hyperglycemia. For most critically ill patients, a target glucose range of 140–180 mg/dL is recommended. In non-critically ill patients, individualized targets generally between 100 and 180 mg/dL are advised, emphasizing avoidance of hypoglycemia and overly tight control. Insulin remains the preferred inpatient therapy.

These RSSDI guidelines provide structured, protocol-driven recommendations tailored to Indian practice to promote standardized and safe inpatient glycemic management.