A study published in the Journal of Diabetes Science and Technology (JDST) provides further evidence that Glytec’s patented eGlycemic Management System® (eGMS®) is safer and more effective than traditional approaches to managing basal-bolus therapy.1 With some 40% of hospitalized patients receiving insulin therapy during their stay, the consequences of inadequate and imprecise dosing -- including increased risk of complications and mortality, longer lengths of stay, and higher readmission rates -- pose significant cost and quality improvement opportunities for hospitals.
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"ADA [American Diabetes Association] guidelines recommend use of basal-bolus insulin for non-critically ill hospitalized patients, and strongly discourage use of sliding-scale. A system like the eGMS® should be the standard of care, and institutions should eliminate sliding-scale," says Joseph P. Aloi, MD, Section Chief, Endocrinology and Metabolism at Wake Forest Baptist Health. (Graphic: Business Wire)
The JDST study, led by Joseph P. Aloi, MD, Section Chief, Endocrinology and Metabolism at Wake Forest Baptist Health, concluded: ‘The complexity of basal-bolus order sets coupled with a lack of diabetes expertise in hospitals is a compounding factor that can result in confusion and ultimately poor patient outcomes and even medical errors. There is growing evidence that adoption of computer-based algorithms, if implemented safely, could potentially reduce the need for personnel, minimize titration inertia and reduce variation in care in this arena.’
The eGMS®, which includes complex, proprietary computer-based algorithms to personalize and dynamically adjust the basal-bolus regimen for each patient, addresses many long-standing barriers to adoption of this preferred treatment, enabling hospitals to eliminate its antiquated, but widely-utilized sliding-scale counterpart.
“This retrospective crossover study demonstrates that an automated insulin dosing decision support system for basal-bolus therapy is both safe and effective, and produces better outcomes than traditional protocols,” says Aloi. “ADA [American Diabetes Association] guidelines recommend use of basal-bolus insulin for non-critically ill hospitalized patients, and strongly discourage use of sliding-scale. A system like the eGMS® should be the standard of care, and institutions should eliminate sliding-scale.”
Hundreds of medical studies and articles published over the past several decades describe the many limitations and inadequacies of sliding-scale insulin therapy (SSI). “Although scientific research and ADA guidelines indeed denounce SSI and advocate for basal-bolus, many clinicians view basal-bolus as too complex and time consuming. Absent our unique eGMS®, basal-bolus is very difficult for hospitals to implement and gain meaningful adoption,” explains Glytec’s Vice President of Clinical Practice, Melanie Mabrey, DNP, ACNP-BC, BC-ADM, CDTC, FAANP. “Our eGMS® eliminates the guesswork, the manual calculations, and the trial and error; it delivers precise and personalized insulin dosing recommendations while improving nursing workflow. For several of our clients, our eGMS® is the only way to order insulin, and is used for greater than 95% of all eligible patients.”
The JDST study notes that many clinicians have a knowledge deficit in proper basal-bolus dosing and titration protocols. Workflow issues surrounding the timing of blood glucose checks, insulin administration and meal tray delivery also contribute to diminished institutional success with basal-bolus.
“Glytec has extraordinary expertise and proven success in facilitating the clinical practice transition from sliding-scale to basal-bolus,” says Mabrey. “Our clinical services organization works with clients to tailor training and education plans, implement best practices, and establish KPIs that can be monitored in real-time with our GlucoMetrics® analytics solution, collectively providing the foundation of a more effective diabetes management program.”
Although the JDST study does not specifically evaluate the economics of the eGMS® versus a paper-based or static order set approach, Aloi recognizes the cost-of-care reductions gained by a fully automated and integrated solution. “The eGMS® is built into the EMR, and the nurses find it very easy to use. The improvements in clinical outcomes speak for themselves, and the savings follow. Less hypo- and hyperglycemia have been proven over and over to translate to fewer complications, shorter lengths of stay, and lower readmission rates.” Hospitals using the eGMS® have realized an annualized savings of as much as $10,000 per licensed bed.
1 J Diabetes Sci Technol. 2016 Aug 23. pii: 1932296816664746.
As a leading innovator in the care of patients with diabetes, Glytec is pioneering the way hospitals and health systems use technology to ensure optimal glucose control and prevent the associated frequency, risks and costs of hyperglycemia and hypoglycemia. The company, founded in 2006, has developed a comprehensive eGlycemic Management System®, or eGMS®, which centers on the only FDA-cleared solution for insulin dosing able to support personalized intravenous and subcutaneous therapy for adult and pediatric populations across the entire care continuum. The solution seamlessly integrates with EMR systems for streamlined use in all inpatient and outpatient settings. It also integrates with connected devices for at-home care managed through telehealth, population health and other value-based programs. The eGMS® employs a cloud-hosted software-as-a-service (SaaS) delivery model, allowing for rapid implementation and anytime/anywhere access. The efficacy of the eGMS®, including its ability to substantively improve clinical and financial outcomes, has been validated by more than 55 published studies. Results have included dramatic reductions in lengths of stay, readmissions and A1c levels. Glytec currently holds five U.S. patents and has an additional 32 U.S. and international patents pending. The company has offices in Waltham, Massachusetts and Greenville, South Carolina. For more information, visit www.glytecsystems.com.
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Last updated on: 04/10/2016
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