Electronics Said to Reduce Hypoglycemic Events

JULY 2, 2016

Electronics Said to Reduce Hypoglycemic Events

New data presented at AACE shows hypoglycemic events are less likely in patients with diabetes treated with an electronic glycemic management system.

In an interview, Joseph Aloi, MD, section chief of endocrinology and metabolism at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, told Diabetes in Control that, “Patients who were treated with the [electronic glycemic management system] had a statistically lower incidence of hypoglycemic events and lower average blood glucose compared with [usual care], suggesting it may be easier to achieve glycemic targets safely for patients in the hospital setting.

Aloi and colleagues from Glytec compared rates of hypoglycemia among inpatients with diabetes treated with Glytec’s electronic glycemic management system (eGMS; n=13,351) or usual care (n=45,335).

Severe hypoglycemia was defined as less than 40 mg/dL and the target blood glucose was set at 100 mg/dL to 180 mg/dL. Three categories of mild to moderate hypoglycemia were defined as less than 70 mg/dL, less than 60 mg/dL and less than 50 mg/dL; and both groups had blood glucose at admission and mean blood glucose measurements.

The system incorporates a patient’s blood glucose information and other factors to calculate an individualized insulin dose, helping patients with diabetes avoid the dangers of hypoglycemia and hyperglycemia.

Current information shows that the prevalence of both hyperglycemia and hypoglycemia in hospitalized patients is increasing and is associated with higher mortality, increased cost of care, and longer lengths of stay. Insulin management and glycemic control are critical components of providing outstanding quality care for a patients, which is why a number of facilities are partnering with Glytec, who has developed this algorithm.

Any hypoglycemia of less than 70 mg/dL occurred in fewer patients treated with the eGMS (13.8%) compared with those treated with normal care (21.7%). The eGMS group also had fewer participants with blood glucose less than 60 mg/dL (6% vs. 13.7%), less than 50 mg/dL (2.5% vs. 7.7%) and less than 40 mg/dL (0.9% vs. 3.6%) compared with the usual care group.

Average blood glucose was lower among the eGMS group (178 mg/dL) compared with the usual care group (188 mg/dL).

The findings suggest that eGMS may be superior to usual diabetes care. Dr. Aloi added that, “By leveraging technology, providers can offer industrialized insulin doses based on risk factors, such as insulin to carbohydrate intake, to quickly and effectively get patients within target blood glucose levels.”

The system uses Glucommander, a clinician-developed, algorithm-based software, that was designed to individualize dosing recommendations for insulin therapy.

“As the healthcare industry continues to move towards value-based care, Glytec is collaborating with healthcare providers across the country to establish a new standard of care in glycemic control and improve patient outcomes across the continuum of care,” Melanie Mabrey, DNP, ACNP-BC, BC-ADM, CDTC, FAANP, vice president of clinical practice at Glytec, said in a news release.

Practice Pearls

  • New electronic glycemic management software can reduce episodes of hypo and hyperglycemia.
  • The software was designed to individualize dosing recommendations for insulin therapy.
  • The findings suggest that eGMS may be superior to usual diabetes care.

Aloi J, et al. “Improved inpatient hypoglycemia rates with electronic glycemic management system.” Presented at: AACE Annual Scientific and Clinical Congress; May 25-29, 2016; Orlando, FA.

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