As a pioneer in technology for glycemic management, Glytec is pleased to share the results of a recent studyconducted at the Fred Hutchinson Cancer Research Center in Seattle, Washington. The prospective study, led by Cora Espina Erickson, ARNP, CWCN and published by Bone Marrow Transplantation,1demonstrates that stringent glucose control among allogeneic hematopoietic cell transplantation (HCT) patients is feasible using Glucommander(TM), the computer-guided glucose management system from Glytec.
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Irl Hirsch, MD and Cora Espina Erickson, ARNP, CWCN, of the University of Washington, are authors of a new study published in the medical journal, Bone Marrow Transplantation, demonstrating that stringent glucose control among transplant patients is feasible using Glucommander, the computer-guided glucose management system from Glytec. According to Hirsch, “Upuntil now, most thought it would be difficult to even consider a clinical trial to assess if glucose control could impact outcomes, including mortality, because our insulin protocols were not robust enough to deal with the high-dose steroids, TPN, and occasional eating all at the same time. The Glucommander system showed in our feasibility study it is indeed possible to control glycemia in this population." (Photo: Business Wire).
Glucommander is the only technology solution on the market that has received FDA clearance (as a Class II medical device) for intravenous and subcutaneous insulin dosing in the treatment of patients both with and without diabetes. Healthcare provider organizations are able to access Glucommander through Glytec’s eGlycemic Management System®, or eGMS®, software-as-a-service. For maximum efficiency and ease of use, Glucommander is most typically integrated with an electronic medical record (EMR) system.
Past studies of HCT patients offer emerging evidence of associations between malglycemia (hyperglycemia, hypoglycemia and glycemic variability) and poor outcomes, including increased rates of non-relapsed mortality (NRM) as high as 20-30%, acute graft versus host disease (GvHD), infections, and organ dysfunction. The team of researchers behind the Espina et al. study hypothesized that stringent glucose control, with prevention of hypoglycemia and glycemic variability, could improve these outcomes for hospitalized HCT patients.
According to Irl B. Hirsch, MD, one of the University of Washington researchers on the Espina et al. study and a luminary in the field of metabolics, "The treatment of steroid-induced hyperglycemia during graft versus host disease in bone marrow transplant patients on the surface seems like it would be important. Up until now, most thought it would be difficult to even consider a clinical trial to assess if glucose control could impact outcomes, including mortality, because our insulin protocols were not robust enough to deal with the high-dose steroids, TPN, and occasional eating all at the same time. The Glucommander system showed in our feasibility study it is indeed possible to control glycemia in this population."
Patients enrolled in the Espina et. al. study underwent allogeneic HCT at the Fred Hutchinson Cancer Research Center, were age 18 or older and satisfied one of two criteria regarding glycemic history: (a) they required insulin therapy due to a known history of type 2 diabetes, or (B) they had experienced two episodes of blood glucose above 180 mg/dL or one episode above 250 mg/dL. Patients who were critically ill (intensive care unit status), terminally ill, had type 1 diabetes or an Eastern Cooperative Oncology Group classification greater than 3 were excluded.
The median blood glucose at initiation of the computer-guided glucose management (i.e., the first reading while on Glucommander) was 244 mg/dL. All patients reached a conventional blood glucose range of 80-180 mg/dL at a median of 3.8 hours, most reached the target range of 100-140 mg/dL at a median of 6 hours, and no severe episodes of hypoglycemia (<40 mg/dL) were detected. Patients maintained the target range 61% of the time while on Glucommander. In comparison, patients were within the target range only 0.58% of the time during the 24 hours prior to initiation of Glucommander and 20.95% of the time during the 24 hours after completion of Glucommander.
Glytec’s Vice President of Quality Affairs, Raymie McFarland, says, “Our company appreciates the spirit and dedication of Cora Espina Erickson and all researchers associated with this study. We recognize the importance of stringent glycemic management for HCT patients, especially in light of high-dose steroids and the need to treat steroid-induced hyperglycemia. We are extremely pleased and excited to see that our Glucommander system proved efficacious.”
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 reduce the 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 insulin dosing solution able to support intravenous and subcutaneous therapy for adult and pediatric populations across the entire care continuum. The eGMS® offers personalized clinical decision support that seamlessly integrates with EMR systems for streamlined use in all inpatient and outpatient settings. It also integrates with connected devices for at-home, provider-directed 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 more than 30 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: 11/10/2016
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