Inpatient Self Monitoring and Administration Study (ISMAS)

Inclusion criteria: 1. Male or female, age \< 80 2. Most recent hemoglobin A1C within the past 6 months \< 12% 3. Recent history of regular self-administered peripheral blood glucose checks as an outpatient 4. Recent history of insulin self-administration at least twice a day as an outpatient 5. Admitted for a hospitalization anticipated to last at least 3 days 6. Mini Mental Status Examination (MMSE) ≥ 25 at admission and the same or better post-operatively 7. All patients will be actively followed by the Endocrinology inpatient consultation team during the hospitalization. Exclusion criteria: 1. Currently receiving peritoneal or hemodialysis 2. Patients with unstable angina 3. History of myocardial infarction within 3 weeks prior to enrollment 4. Current admission due to or associated with altered mental status or encephalopathy 5. History of an episode of altered mental status or encephalopathy within the 4 weeks prior to enrollment 6. A confirmed diagnosis of dementia 7. Inability to self-adjust insulin 8. No recent history of ability to perform regular peripheral blood glucose checks 9. Frequency of hypoglycemia (\< 60 mg/dL) \> twice/week by history 10. Inability to eat without assistance 11. Study objectives will not be pursued in patients during stays in any intensive care unit.