Effect of Inpatient Diabetes Management on Outpatient Glycemic Control

Inclusion Criteria: * Age \> 18 years * Known diagnosis of type 2 diabetes by history with outpatient prescription of oral hypoglycemic medication or insulin * Hemoglobin A1c \> 8.0% within the prior 12 months, or if not known, fasting blood glucose greater than 200 mg/dl on sliding scale regular insulin. * Partners-affiliated primary care physician Exclusion Criteria: * Screening HbA1c returns less than 8%. * Diabetic ketoacidosis (DKA) as a primary reason for admission (admission blood glucose \> 250 mg/dl with arterial pH \< 7.30 or serum bicarbonate level \< 15 mg/dl), or development of DKA during admission. * Hyperosmolar hyperglycemic syndrome as a primary reason for admission (admission blood glucose \> 400 mg/dl and plasma osmolality \> 315 mOsm/kg. * Pregnancy, ruled out by urine HCG test at screening after consent is obtained in all women who continue to have menstrual cycles. * Anemia with hemoglobin \< 9 g/dl, recent blood transfusion, or need for blood transfusion (interferes with interpretation of hemoglobin A1c assay) * End stage liver disease with prothrombin time \> 15 seconds and albumin \<3 mg/dl * End stage renal disease: Stage IV (glomerular filtration rate \<30 mg/dl) or V chronic kidney disease * Treatment with corticosteroids * ICU transfer * Inability to self-administer insulin * Hypoglycemia unawareness: patient lacks sensation of common signs of blood glucose \< 60 mg/dl (tachycardia, diaphoresis, hunger, confusion, fatigue). * Projected survival \< 1 year