eGlycemic Management System Provides Safe and Effective Glycemic Control for Stroke Patients Requiring Subcutaneous Insulin in the Hospital Setting
Presentation
Annual Diabetes Technology Meeting
Date
October 2015
Authors
Jagdeesh Ullal, Melanie Mabrey, Amy Henderson, Raymie McFarland, Robby Booth, Joseph Aloi
Objective
Admission hyperglycemia (>130 mg/dL) and persistent inpatient hyperglycemia (>48 hours) have been predictors of poor patient outcomes, including higher mortality, higher rates of in-hospital complications and longer length of stay in patients with acute ischemic stroke. This study evaluated the glycemic outcomes of patients using eGMS Subcutaneous (eGMS-SQ) for subcutaneous insulin management versus Standard Subcutaneous Orders (SSO) in patients with Acute Ischemic Stroke.
Methods
The study evaluated 40 patients with type 2 diabetes mellitus at Sentara Health System who required SubQ insulin to manage hyperglycemia. Qualifying patients 2 blood glucose levels >180 mg/dL were treated with eGMS-SQ or SSO with a target of 120-160 mg/dL. The efficacy and safety of each was evaluated by the following:
(1) BGs 71-180 mg/dl
(2) BGs >180 mg/dl
(3) Hypoglycemic events
(4) Average BG and Average LOS
Results
Patients (n = 20) treated with eGMS-SQ had a starting BG of 232 mg/dL, average BG 149 mg/dL, 74.7% of readings in target, hypoglycemia <70 mg/dL was 2.1% and hypoglycemia <40 mg/dL was 0.0%. Average LOS using eGMSSQ was 5.3 days. Patients (n = 20) treated with SSO had a starting BG of 235 mg/dL, average BG on eGMS-SQ 169 mg/dL, 56.8% of readings in target, hypoglycemia <70 mg/dL was 4.4% and Hypoglycemia <40 mg/dL was 0.5%. Average LOS using SSO was 6.4 days.
Conclusion
These results suggest eGMS-SQ can effectively and more importantly safely control and maintain glucose control for patients with Acute Ischemic Stroke. A higher percentage of patients reached target glucose levels, had over 50% less hypoglycemia <70 mg/dL and a significantly lower LOS was observed.
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