MAY 4, 2017
Study Shows Computer-Guided Insulin Titration Enables Basal Bolus Standard of Care
New research presented at the AACE 26th Annual Congress further validates that use of Glytec’s eGlycemic Management System® eliminates barriers to adoption of basal bolus insulin and produces superior patient outcomes.
WALTHAM, MA — A multi-center post-hoc analysis presented at the American Association of Clinical Endocrinologists (AACE) 26th Annual Scientific & Clinical Congress by Drs. Jagdeesh Ullal and Joseph Aloi demonstrates that Glytec’s eGlycemic Management System® (eGMS®) enables hospitals to achieve the basal bolus standard of care for subcutaneous insulin therapy with extraordinary efficiency and superior patient outcomes. The new research study, entitled ‘AUTO Study, AUtomatic Titration tO Target: Subcutaneous Basal Bolus Insulin Management Using eGMS in the Non-ICU Setting,’ observed a 19% reduction in average daily blood glucose between admission and discharge — with 0.00% severe hypoglycemia < 40 mg/dL — while achieving the prescribed target blood glucose of 140-180 mg/dL at all mealtime and bedtime intervals.
The study draws attention to the tremendous opportunity for improvements in quality and patient safety at some 80% of hospitals that continue using sliding scale insulin. “The medical community for the most part knows that AACE and ADA [American Diabetes Association] recommend basal bolus as the standard of care, yet sliding scale insulin persists,” explains Aloi, Section Chief, Endocrinology and Metabolism at Wake Forest Baptist Medical Center. “There are many reasons for this, and they are well documented. We understand that in the absence of a software platform to guide insulin titration, basal bolus is more difficult to implement and sustain than sliding scale; and many clinicians who don’t practice endocrinology or diabetology find basal bolus time-consuming and confusing. We observed in the AUTO Study, and in previous studies, that by providing automated decision support for insulin titration, much of the clinician’s burden is removed, making basal bolus processes much simpler.”
With eGMS®, instead of having to manually adjust subcutaneous basal bolus insulin doses four times a day, and enter new orders to the EMR, clinicians place a single order to initiate insulin therapy. The software platform responds by computing daily dosing recommendations for breakfast, lunch, dinner and bedtime.
“As a diabetes specialist and someone who works in daily practice to optimize care, I fully appreciate the effort it takes clinicians to adopt basal bolus protocols,” says Ullal, an endocrinologist at Sentara Healthcare and Associate Professor at Eastern Virginia Medical School. “In the AUTO Study, using the eGMS® platform translated to the difference between one order for insulin and 24 separate orders for insulin over the course of six days of therapy. Without the eGMS® platform, clinicians have to manually perform all the dosing adjustments and manually enter all those orders. I can say with conviction, the eGMS® platform not only delivers excellent clinical results, it is extremely efficient and time-saving for clinicians.”
The AUTO Study included glycemic data from 1,687 non-critically ill patients treated with subcutaneous insulin therapy between July 2016 and January 2017. Nine hospitals participated in the study. The abstract and poster presented at the AACE 26th Annual Scientific & Clinical Congress is available online (click here).
Raymie McFarland, Vice President of Quality Initiatives at Glytec, who manages Glytec’s research programs, summarizes as follows: “Lack of information systems coupled with misconceptions and knowledge deficits have left clinicians challenged to manage basal bolus workflows. To manually implement and sustain basal bolus insulin therapy is hard. Glytec not only delivers an evidence-based software platform to support insulin titration, hyperglycemia surveillance and analytics, we ensure our clients are well equipped to undertake the requisite clinical practice change. We have substantial expertise in basal bolus adoption methodologies, and the comprehensive professional services program we’ve developed has helped our clients achieve utilization rates at or above 95% of eligible patients.”
Founded in 2006, Glytec is the pioneer and leader in diabetes therapy management software, enabling healthcare organizations to achieve best practice for glucose control and standardize care for inpatients and outpatients alike. The company’s comprehensive eGlycemic Management System® (eGMS®) has been proven to dramatically reduce drivers of cost and clinical variation, including incidence of hypoglycemia, readmissions, length of stay, complications and A1C levels. Its efficacy and safety have been validated by more than 55 research studies. eGMS® centers on an FDA-cleared insulin dosing solution that supports personalized intravenous and subcutaneous therapy for adult and pediatric populations. It integrates seamlessly with EMR systems and connected device platforms for streamlined use across the entire continuum of care, including at-home, provider-directed care managed through telehealth, population health and other value-based programs. The company’s cloud-hosted software-as-a-service (SaaS) delivery model allows for rapid implementation and anytime, anywhere access. Glytec has offices in Waltham, Massachusetts and Greenville, South Carolina. For more information, visit www.glytecsystems.com.