Prospective trials have demonstrated reductions in hyperglycemic measurements, hypoglycemia, and adjusted hospital length of stay when physiologic subcutaneous insulin protocols are used. Insulin sensitivity, nutritional intake, and total daily dosing review can alter the physiologic insulin-dosing schedule. This correctional dose resembles a sliding scale, but is only a small fine-tuning of therapy, as opposed to traditional sliding-scale insulin alone. A correctional insulin dose provides a final insulin adjustment based on the preprandial glucose value. The initial total daily dose of subcutaneous insulin is calculated using a factor of 0.3 to 0.6 units per kg body weight, with one half given as long-acting insulin (the basal insulin dose), and the other one half divided daily over three meals as short-acting insulin doses (nutritional insulin doses). New physiologic subcutaneous insulin protocols use basal, nutritional, and correctional insulin. Evidence for the effectiveness of sliding-scale insulin is lacking after more than 40 years of use. Despite persistent expert recommendations urging its abandonment, the use of sliding-scale insulin remains pervasive in U.S. Glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory.