OBJECTIVE To identify the many roles of the hospital pharmacist in improving the health and outcomes for in-patients experiencing episodes of hyperglycaemia. METHODS Information for this article was selected from articles found on MEDLINE between 1998 and 2008 on the topics of hospital management of hyperglycaemia and type 2 diabetes. The article was further developed according to the clinical experiences of the author. RESULTS When discussing the identification and treatment of hyperglycaemia in hospitalized patients, it is important to include the many aspects of glycaemic control that can be provided by hospital pharmacists. These include tasks such as patient screening and identification, monitoring glycaemic parameters, documenting therapy and therapeutic end points, and evaluating prescribing habits. Risk evaluation, guideline implementation, and a coordinated multi-disciplinary approach to discharge planning can be used to improve diabetes management by incorporating the entire hospital health-care team in patient care and education. CONCLUSIONS Hospital pharmacists should develop and implement protocolized care for the management of patients with hyperglycaemia throughout the institution in order to optimize the efficacy and safety of insulin therapy.