Clinical Impact of Using eGlycemic Management System for Insulin Therapy at a Large Academic Medical Center

In by Heather DelCarpini

Clinical Impact of Using eGlycemic Management System for Insulin Therapy at a Large Academic Medical Center

Presentation

International Hospital Diabetes Meeting

Date

May 2017

Authors

Marina Rabinovich, Barbara McLean, Guillermo Umpierrez

OBJECTIVE

The benefits of optimal glycemic control in hospitalized patients have been widely studied and strategies should focus on controlling hyperglycemia and avoiding hypoglycemia. The primary objective of this study was to compare hypoglycemia among critically ill patients at a large academic medical center receiving insulin therapy by usual care versus eGlycemic Management System (eGMS). Secondary objectives were additional glycemic measures.

METHODS

Retrospective, single academic medical center comparison of patients receiving insulin therapy by usual care (UC) before and after implementation of eGMS. UC data collected from 8/17/16 to 1/29/17 and eGMS post go-live from 10/24/16 to 1/29/17.

PATIENT DEMOGRAPHICS Usual Care eGMS
#Patients 2,079 90
Median Age (yrs) 53 60
Gender – Male 49% 36%
Gender – Female 51% 64%
Height (cm) 163.51 171.64
Weight (kg) 81.76 86.75
BMI 29.02 29.56
A1c 8.97 9.35
GFR 42.88 48.0

RESULTS

For patients receiving UC (n=2,079), 32,850 blood glucose (BG) values were evaluated.

  • The average initial BG was 241.48 mg/dL (SD=205.35), and the average final BG was 180.21 mg/dL (SD=98.16).
  • 26.3% of patients (n=547) experienced hypoglycemia <70 mg/dL, and 8.13% (n=169) experienced severe hypoglycemia <40 mg/dL.
  • 5.73% of BGs (n=1,881) were <70 mg/dL, and 1.11% (n=363) were <40 mg/dL.

For patients receiving care using eGMS (n=90), 7,615 BG values were evaluated.

  • The average initial BG was 274.94 mg/dL (SD=99.29, p <0.0001), and the average final BG was 160.76 mg/dL (SD=48.74, p <0.0001).
  • 12.2% of patients (n=11, p <0.0001) experienced hypoglycemia <70 mg/dL, and 2.22% (n=2, p <0.0001) experienced severe hypoglycemia <40 mg/dL.
  • 0.28% of BGs (n= 21, p <0.0001) were <70 mg/dL, and 0.03% (n=2) were <40 mg/dL.

CONCLUSION

Compared to usual care, eGMS can significantly reduce adverse effects associated with insulin therapy in hospitalized patients while effectively optimizing glucose control in a large academic medical center environment.

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