Closing the glucose gaps in hospital diabetes care. Managing editor, diabetes advocate and person with type 1 diabetes, Mike Hoskins.

In by Heather DelCarpini

DECEMBER 21, 2015

Closing the glucose gaps in hospital diabetes care. Managing editor, diabetes advocate and person with type 1 diabetes, Mike Hoskins.

Mike Hoskins, a person living with type 1 diabetes and Managing Editor of DiabetesMine (web log focused on diabetes advocacy), delivers straight talk on the state of inpatient diabetes care and the role of Glytec’s solutions in quality improvement and patient safety.

Seems logical that you’d have some of the best medical care and attention to your diabetes if you’re in a hospital surrounded by on-call experts, right?!.


That’s often not the case. The poor state of diabetes management in hospitals has been experienced first-hand by many of us in the Diabetes Community and even my own family in recent years. It’s not a pretty picture in some places. Stats prove it can cost upwards of $110 billion annually, in large part due to the time and energy it takes to attempt to manage individual patients’ diabetes needs in these high-pressure facilities -- where so many PWDs (people with diabetes) face the risk of dangerously high or low blood sugars, and even death.

But thankfully, this need is being recognized and some entrepreneurs are rolling out innovations that can potentially change the game.

It’s actually strange that we haven’t heard more about these solutions, as at least one has been on the scene for close to a decade now: Glytec, offering a platform to help automate insulin dosing calculations and care decisions

Glytec - Automating Insulin Dosing for Hospitals

This digital health tech company is based in Waltham, MA (west of Boston) and also has offices in South Carolina. It was established 2006, and that same year it received initial FDA clearance on its system dubbed Glucommander. As you can tell from that clever name, the goal is to give nurses and hospital staff a chance to be in command of glucose levels.

Glucommander allows these healthcare professionals to “go paperless,” eliminating the traditonal hospital process of filling out paper protocols and physically submitting this paperwork to a doctor for approval before treatment can be delivered. With Glucommander, hospital staff is able to simply enter a BG result into the e-system or mobile app version of Glucommander, which uses its own algorithm to calculate proper insulin dosing, without the need a doctor’s intervention each time. This is FDA approved for IV, subcutaneous insulin delivery for both adults and children.

It’s kind of like having a mobile bolus advisor in the hospital setting. With Glucommander, a nurse can quickly take a fingerstick test on the patient, enter the BG result into the system, and immediately receive a recommended insulin dose and timing for the next BG check. If the hospital happens to be using one of the few inpatient glucose meters with wireless access, the result can also be directly beamed into Glucommander.

It’s been close to a decade since Glucommander started hitting hospitals, and the company tells us the system is installed in over 100 hospitals around the country now, with more than half of those added in just the past 18 months. And that number is growing rapidly. Glytec also has CE Mark approval for Europe and plans to start international efforts in 2016.

The company’s website features video testimonials from hospital folk talking about how much this has helped them, and their patients, and Glytec’s Chief Medical Officer Andrew Rhinehart says the real-life data and clinical research presented over the years speaks for itself.

Nurses are very enthused about getting this type of tech to help them in their jobs, Rhinehart notes, citing one hospital where Glytec is now implementing it’s system that to date has been using a paper protocol that requires nurses to thumb through eight pages of documents to determine a single insulin dose. YIKES!

We asked Glytec if PWDs are able to look up whether our local hospitals are using Glucommander, but as of now that locator tool doesn’t exist. We’re told they hope to offer it soon.

Glucommander is actually a part of the company’s bigger picture eGMS (Glucose Management System) that includes mobile health options for hospital and inpatient staff, that is now being expanded beyond just the critical care inpatient facilities. In November, Glytec released study data showing an A1C reduction in an outpatient setting for PWDs with both T1 and T2 diabetes using Glucommander.

Glytec has published 45+ studies through the years showing the eGMS impact, and in the first half of next year Rhinehart says they’ll be publishing another new study comparing hypoglycemia rates for 60,000 patients across 32 hospitals, and that data on clinical and financial impact “is dramatic.”