Use of a Computer-Based Insulin Infusion Algorithm to Treat Diabetic Ketoacidosis in the Emergency Department

Diabetes Technology & Therapeutics
Jagdeesh UllalJoseph Aloi

Abstract

Efforts at improving quality metrics in diabetes focus on minimizing adverse events and avoiding re-admissions to the hospital. Our experience with Glucommander™ (Glytec, Greenville, SC), a cloud-based insulin management software system, suggested that its use in the emergency department (ED) would be useful in treating patients with mild diabetic ketoacidosis (DKA). Thirty-five patients seen in the ED with hyperglycemic crises and diagnosed with DKA during one calendar year were reviewed. A retrospective chart review was performed on patients who were placed on Glucommander™ for DKA management. We excluded patients with significant acidosis or concomitant medical illnesses. Initial average capillary glucose level was 487 ± 68 mg/dL, average time to target glucose was 5 h 11 min, and rate of hypoglycemia (blood glucose level <70 mg/dL) was less than 0.3%. Sixteen patients treated with the protocol were discharged from the ED directly, and 19 were admitted. Patients were maintained for an average of 14 ± 1 h on the Glucommander™ protocol. There was a significantly higher anion gap (P = 0.002) and lower serum bicarbonate level (P = 0.006) in the admitted group. We found very low evidence of re-admission (6%) within 30 days of dis...Continue Reading

References

Feb 24, 2001·Diabetes Care·A E KitabchiB M Wall
Jul 28, 2004·Diabetes Care·Guillermo E UmpierrezAbbas E Kitabchi
Nov 30, 2014·Journal of Community Hospital Internal Medicine Perspectives·Chi Tang, Ruth Kouides

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Citations

Jan 3, 2018·Journal of Diabetes Science and Technology·Jagdeesh UllalGuillermo E Umpierrez
Jan 23, 2020·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Anna Y GroysmanStanislaw Klek
Mar 28, 2018·Current Diabetes Reports·Susan Shapiro BraithwaiteOluwakemi T Soetan
Sep 29, 2019·World Journal of Diabetes·Alex Renato MonteroMichelle F Magee
Nov 10, 2020·Current Diabetes Reports·Preethika S EkanayakeKristen Kulasa

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