Back to Basics: Why Now is The Time to Prioritize Standard of Care for Glycemic Management

The American Diabetes Association (ADA) and other healthcare leaders have long emphasized the importance of safe and effective glycemic management in the hospital. The reason? Diabetes and other forms of glycemia cut across disease states and impact how care should be delivered in nearly every hospital department.  

When we zoom out, about 1 in 4 healthcare dollars is spent caring for people living with diabetes. Roughly 40% of the United States population lives with either diabetes or prediabetes. And up to 50% of patients in the hospital may meet criteria for insulin during their stay.  

Moreover, decades of research have shown that quickly achieving a target glycemic range positively impacts patient outcomes. Lower rates of hyper- and hypoglycemia improve mortality and morbidity rates and reduce lengths of stay, readmissions, and cost of care. In fact, poor blood glucose control can increase the length of stays by up to 3 days and cost hospitals thousands of dollars per patient.    

Simply put, glycemic management is essential to safe and quality care. 

But it's no secret the healthcare community (and the world) underwent a life-altering experience during the global pandemic. And we saw the impact COVID-19 had on those with underlying conditions firsthand. Glytec research suggested that people with glycemic control issues had mortality rates four times higher than patients without.  

As a result, overcapacity and understaffed hospitals went into triage mode. Healthcare workers fought to keep patients alive while keeping themselves safe. At times, that meant deviating from how we traditionally deliver care in certain areas.  

Since glycemic management is typically not the primary reason for admission, it was one of the areas where hospitals strayed from known best practices to put every ounce of energy towards addressing a global health crisis. But as we emerge from the pandemic smarter and more unified, it's time to reignite the glycemic management momentum and get back to best practices advocated by groups including ADA and Society of Hospital Medicine (or TJC, or Leapfrog, or Endocrine Society):  

• Insulin should be used for the majority of hospitalized patients with hyperglycemia. 
• Continuous intravenous insulin infusion should be utilized to treat persistent hyperglycemia in critically ill patients. 
• Intravenous insulin infusions should be administered based on validated written or computerized protocols that allow for predefined adjustments in the infusion rate, account for glycemic fluctuations and achieve low rates of hypoglycemia. 
• The use of only a sliding-scale insulin regimen in the inpatient hospital setting is strongly discouraged. 
• A basal insulin or a basal plus bolus correction insulin regimen with mealtime adjustments as warranted is preferred to treat noncritically ill hospitalized patients. 
• Transition patients to subcutaneous insulin schedules using institutional protocols before discontinuing intravenous insulin infusions. 

The good news is you don't have to go at it alone. You can join your fellow hospital executives, healthcare providers and industry leaders to explore the glycemic management standard of care in detail during our annual virtual Time to Target Conference on October 25-26, 2023.  

This year's theme is the Glycemic Management Journey. So, we'll explore the importance of prioritizing inpatient glycemic management while sharing how to assemble the right people, create processes that support quality improvement and leverage technology to achieve success in your health system. Some sessions that dive deeper into these topics you won’t want to miss, include: 

• Preparing for the CMS Glycemic Measures: Leveraging Quality Improvement | 10/25 at 4:10 pm ET
• Glycemic Management Committees: Empowering Healthcare Excellence Through Collaborative Care | 10/26 at 1:30 pm ET
• Optimizing DKA Management: A Comprehensive Approach to Order Sets & Guidelines | 10/26 at 3:20 pm ET

Together, #LetsDoA180! We can #PreventHypo and #StopSlidingScaleOnly. Please consider registering for our annual event and utilizing these hashtags during the conference and throughout the rest of 2023 as part of Glytec's safety campaign.