Hyperglycemia Management Strategies to Reduce Infections and Morbimortality in Hospitalized Patients: A Scoping Review.

Hyperglycemia is a frequent complication in hospitalized patients and is strongly associated with increased morbidity, mortality, and length of stay. It is characterized by elevated blood glucose levels during hospital admission, occurring in both diabetic and non-diabetic patients, and represents a significant challenge in clinical management (Brazilian Diabetes Society, 2015; Golbert, 2020; Marino et al., 2021; Marino et al., 2023). Glycemic control strategies are considered effective interventions for reducing hospital complications, including decreased infection rates, shorter intensive care unit stays, and improved wound healing. In hospitalized patients, intensive insulin therapy has been observed to minimize derangements in normal host defense mechanisms, reduce polymorphonuclear leukocyte dysfunction, and modulate the release of inflammatory mediators (Umpierrez et al. 2002, Moreira et al., 2016; Moreira, 2017; Couto et al., 2021). Moreover, studies suggest that maintaining blood glucose concentrations between 140-180 mg/dL significantly decreases infection-related complications and mortality rates. Proper glycemic management has also proven effective in reducing hospital readmissions and healthcare costs. Therefore, structured hyperglycemia management protocols can be effective strategies to prevent and treat hospital-associated complications (Golbert, 2020; Marino et al., 2021; Marino et al., 2023; Brazilian Diabetes Society, 2025). It is expected to investigate the effects of different glycemic control strategies on infection-related outcomes and map how hyperglycemia management can contribute to a better understanding of physiological mechanisms and therapeutic effects in hospitalized patients (Marino et al., 2023; Brazilian Diabetes Society, 2025). There is already a scoping review addressing the consequences of hyperglycemia in hospitalized patients (Olariu, E., Pooley, N., Danel, A., Miret, M., & Preiser, J. (2018). A systematic scoping review on the consequences of stress-related hyperglycaemia. PLoS ONE, 13(4), e0194952). However, this new scoping review will be conducted with a different focus. Furthermore, the research question for the current scoping review is broader and aims to cover not only the consequences of hyperglycemia but specifically the management strategies used to reduce infection-related morbidity and mortality in both critical care settings and general hospital wards. In this way, it will be possible to map the current approaches to glycemic control protocols and identify gaps in the literature regarding evidence-based implementation and effectiveness.