SEPTEMBER 29, 2015
New Study Demonstrates That Improvements in Glucose Control Reduced Complications After Heart Surgery
Study from Emory University published in Diabetes Care leverages Glytec’s Glucommander IV platform to evaluate the optimal level of glycemic control needed to improve outcomes.
Waltham, MA — Glytec, the pioneer and leader in providing innovative glucose management software solutions central to effective diabetes management, is pleased to share the results of the GLUCO-CABG trial(1) conducted by Emory University, which demonstrated intensive insulin therapy resulted in a reduction in post cardiac surgery complications. Hyperglycemia is common in patients undergoing cardiac surgery, reported in 60-90 percent of patients with a known history of diabetes and in more than half of patients without diabetes(2-3).
The randomized controlled trial, conducted leveraging Glytec’s Glucommander™ IV, an FDA-cleared solution which establishes glycemic control via accurate, patient-specific insulin dosing, looked at a total of 302 patients after coronary artery bypass graft (CABG) surgery. Results demonstrated that providing more precise insulin dosing via the Glucommander™ IV led to improved glycemic control and a significant reduction in the rate of hypoglycemia, which is a common side effect of intensive insulin therapy in patients undergoing cardiac surgery.
“The results of the GLUCO-CABG trial indicate that glucose control in patients with type 2 diabetes undergoing CABG surgery is associated with a reduction in post-surgery complications,” said Dr. Guillermo E. Umpierrez, the lead author of the study. “The Glucommander™ IV algorithm allowed us to randomize patients to different glucose targets with a low rate of hypoglycemic events. The study found the rates of complications were reduced by 20 percent in patients with diabetes and 40 percent in non-diabetic patients with hyperglycemia compared to conservative insulin therapy.”
Using the Glucommander™ IV platform’s predictive dosing algorithms for patients requiring IV insulin, the midpoint of the prescribed target range for both targets was able to be achieved throughout this study, and rates of hypoglycemia were significantly lower than that observed in previous randomized clinical trials in the ICU. Only 12 patients (8 percent) during Continuous Insulin Infusion (CII) in the intensive care group and 5 patients (3 percent) in the conservative group experienced mild hypoglycemia (<70 mg/dL), and no patients experienced a glucose value <40 mg/dL. Further, glucose average concentration was lower in patients randomized to the intensive insulin therapy than those in the conservative treatment group.
“Prior intensive insulin studies, including NICE-SUGAR(4) and the Leuven(5) studies, have shown a high risk of hypoglycemia using manual insulin dosing protocols. In this study, more precise dosing via Glucommander™ IV eliminated severe hypoglycemia and reduced the rate of mild hypoglycemic events,” said Andrew S. Rhinehart, MD, FACP, FACE, CDE, BC-ADM, CDTC, Chief Medical Officer, Glytec. “Not only did this study demonstrate Glucommander™ IV’s ability to limit hypoglycemia risk, the data also tells us that it may be time for clinicians to once again reevaluate appropriate targets for patients.”
The study was published in the September 2015 issue of Diabetes Care (Volume 38) and also appeared in the publication’s July online version. To see the study online, please see here: http://care.diabetesjournals.org/content/early/2015/07/08/dc15-0303.
- Umpierrez et al, Randomized Controlled Trial of Intensive Versus Conservative Glucose Control in Patients Undergoing Coronary Artery Bypass Graft Surgery: GLUCO-CABG Trial. Diabetes care 2015;38:1665-1672.
- McAlister FA, Man J, Bistritz L, Amad H, Tandon P. Diabetes and coronary artery bypass surgery: an examination of perioperative glycemic control and outcomes. Diabetes Care 2003;26:1518-1524.
- Schmeltz LR, DeSantis AJ, Thiyagarajan V, et al. Reduction of surgical mortality and morbidity in diabetic patients undergoing cardiac surgery with a combined intravenous and subcutaneous insulin glucose management strategy. Diabetes Care 2007;30:823–828.
- The NICE-SUGAR Study Investigators. Intensive versus Conventional Glucose Control in Critically Ill Patients. N Engl J Med 2009; 360:1283-1297 March 26, 2009 DOI:10.1056/NEJMoa0810625.
- van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001 Nov 8;345(19):1359-67.
Founded in 2006, Glytec is a rapidly growing digital heath company specializing in advanced technology for diabetes management. eGMS®, Glytec’s glycemic management information system, enables providers, payers and patients to significantly reduce the frequency, risks and costs of hyperglycemia and hypoglycemia. The cloud based, modular eGMS® centers on the Glucommander™ Suite of FDA-cleared, predictive dosing algorithms for IV, subcutaneous and pediatric dosing: Glucommander™ IV (FDA clearance 2006), Glucommander™ SubQ (FDA clearance 2010) and Glucommander™ Pediatrics (FDA clearance 2012). Comprehensive management of patients requiring insulin therapy is further enabled by seamless EHR integration (SmartClick) and robust analytics (Glucometrics) and surveillance (GlucoSurveillance) capabilities. The unique breadth and depth of the eGMS® interventional clinical decision support tools allows providers to standardize its process and individualize treatment across all areas of care, and is proven to result in significant improvements in clinical and financial outcomes versus traditional methods. For more information, please visit http://www.glytecsystems.com.