Jordan Messler, MD, Executive Director of Quality Initiatives, explains Glytec’s new research and how Glytec is here to support healthcare providers during the COVID-19 health crisis
As the coronavirus pandemic unfolds, the CDC has reported that people with underlying medical conditions, including cardiovascular disease, diabetes, or other immunocompromised conditions, appear to be at higher risk for severe illness and even death. To look deeper, the team at Glytec, alongside our trusted clinical partners, has worked tirelessly to understand the impact of glycemic characteristics on clinical outcomes of COVID-19 patients hospitalized in the United States (U.S.).
Today, we released the first published research that demonstrates acutely hyperglycemic patients hospitalized with COVID-19, irrespective of diabetes diagnosis, have a higher mortality rate than patients without hyperglycemia.1
The Observational Study
Glytec's peer-reviewed study, published in the Journal of Diabetes Science and Technology, evaluated 1,122 COVID-19 patients between March 1 and April 6, 2020. Data was transmitted from the Glytec database from 88 hospitals in 11 states, representing all four major U.S. regions. All patients had a laboratory-confirmed diagnosis of COVID-19, and 40% were designated as having diabetes, defined as an A1C ≥ 6.5%, or hyperglycemia.1
The study showed that people with glycemic control issues had an in-hospital mortality rate more than four times higher than patients without diabetes or hyperglycemia.1
A subset of 184 patients with diabetes and/or hyperglycemia, and not active cases in the hospital, were identified. In this group, 42% of patients who had no evidence of diabetes before being admitted, and developed hyperglycemia during their stay, died in the hospital. This represents a mortality rate seven times higher than patients living without diabetes or hyperglycemia.1
The study also documented data on increased lengths of stay. Among the 493 patients who survived to discharge, the combined diabetes and uncontrolled hyperglycemia patient group experienced a significantly longer median length of stay of 5.7 days, compared with patients without diabetes or hyperglycemia (4.3 days).1
Offering Our Support
The initial analysis of the report provides what we believe are new insights into hospitalized COVID-19 patients. We believe the data suggests an opportunity exists for clinicians to intervene in acutely hyperglycemic patients to achieve guideline-directed glycemic targets and help improve health outcomes.
Beyond the critical findings from the observational study, we want to continue to help the healthcare community in any way possible during these challenging times. To that extent, we've:
- Offered our research to the public, here.
- Summarized the high-level takeaways of our research.
- Created an information center with insulin management and COVID-19 resources, here.
- Made our team of doctors, nurses and diabetes educators available to share feedback on COVID-19-related questions. (Contact us here.)
- Waived all fees for bed additions of our Glucommander software to help current customers support increased capacity in their hospitals.
Support Tools for Insulin Titration Moving Forward
With up to one-third of all hospital patients experiencing glycemic issues due to diabetes, drug reactions, stress and other factors, managing blood glucose levels in health systems is paramount at all times.2-3
For more than 14 years, Glytec has focused on delivering personalized insulin management. Glytec's FDA-cleared titration software, Glucommander, utilizes proprietary algorithms to provide trained healthcare professionals with computer-generated dosing recommendations that dynamically adjust to each patient's blood glucose trends, insulin sensitivities and response to therapy. The powerful software delivers glucose surveillance, patient risk identification, glycemic status monitoring, reporting and more.11
Patients with, and without, comorbidities, have benefited from the software for improved insulin management, including dramatic reductions in hypoglycemia, hyperglycemia, lengths of stay, readmissions, A1C levels and costs of care.4-7
Glytec's offering has also helped nearly 300 inpatient facilities transition away from paper protocols for hospitalized patients, and our SubQ customers have transitioned to basal-bolus insulin, as recommended by the American Diabetes Association8-9. Additionally, our clients have sustained enterprise-wide utilization at, or above, 95% of eligible patients and annualized cost savings as high as $20,000 per licensed bed7-10. By providing patient-specific computer-generated dosing recommendations, our solution simplifies workflows for clinicians and nurses, enabling them to deliver better care and spend more time with patients.7
If there’s anything the Glytec team or I can do to support your or your organization during this challenging time, please don't hesitate to reach out.
Jordan Messler, MD
Jordan Messler, MD is a hospitalist with Morton Plant Hospitalist group in Clearwater, Florida (serving BayCare Health) and an Executive Director of Quality Initiatives with Glytec. He previously chaired the Society of Hospital Medicine’s Quality and Patient Safety Committee and has been active in several of their mentoring programs, including Project BOOST and Glycemic Control.
- Bode B, Garrett V, Messler J, McFarland R, Crowe J, Booth R, Klonoff DC. Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States. J Diabetes Sci Technol. 2020; In press.
- Agency for Healthcare Research and Quality (AHRQ), Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS) 2015. Nov 2017
- Draznin B, et al. PRIDE Investigators. Pathways to quality inpatient management of hyperglycemia and diabetes: a call to action. Diabetes Care. 2013 Jul;36(7):1807-14.
- Rabinovich M, McLean B, Umpierrez G. Clinical Impact of Using eGlycemic Management System for Insulin Therapy at a Large Academic Medical Center. 2017; International Hospital Diabetes Meeting
- Rabinovich M, Grahl J, Durr E, Gayed R, Chester K, McFarland R, McLean B. Risk of Hypoglycemia During Insulin Infusion Directed by Paper Protocol Versus Electronic Glycemic Management System in Critically Ill Patients at a Large Academic Medical Center. 2018 Jan; Journal of Diabetes Science and Technology
- Mumpower A, Hou S, Parsons T, McFarland R. Relationship Between Glycemic Control Using eGMS and Readmission Rates in Cardiovascular Patients Hospitalized with AMI, CHF or Undergoing CABG During the Implementation of a System Wide Glycemic Initiative. 2016; Annual Diabetes Technology Meeting
- Newsom R, Patty C, Camarena E, Sawyer R, McFarland R, Gray T, Mabrey M. Safely Converting an Entire Academic Medical Center From Sliding Scale to Basal Bolus Insulin via Implementation of the eGlycemic Management System. 2018; Journal of Diabetes Science and Technology.
- Jacobi et al. Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Critical Care Medicine: December 2012 - Volume 40 - Issue 12 - p 3251-3276 doi: 10.1097/CCM.0b013e3182653269
- Gosmanov AR, Gosmanova EO, Dillard-Cannon E. Management of adult diabetic ketoacidosis. Diabetes Metab Syndr Obes. 2014;7:255–264. Published 2014 Jun 30. doi:10.2147/DMSO.S50516
- Newsom R. Journal of Diabetes Science and Technology 2018, Vol. 12(1) 53–59