Use of the eGlycemic Management Solution by Glytec Achieved ADA Glycemic Targets With Low Hypoglycemia for Patients Managed on Subcutaneous Insulin Therapy

Use of the eGlycemic Management Solution by Glytec Achieved ADA Glycemic Targets With Low Hypoglycemia for Patients Managed on Subcutaneous Insulin Therapy

Presentation

International Hospital Diabetes Meeting

Date

May 2015

Authors

Melanie Mabrey, Joseph Aloi, Paul Chidester, Jagdeesh Ullal, Amy Henderson, Raymie McFarland, Robby Booth

Objective

American Diabetes Association guidelines recommend a basal bolus correction insulin regimen as the preferred method of treatment for non-critically ill hospitalized patients. The target for premeal blood glucose (BG) of <140 mg/dL and random BG of <180 mg/dL are well defined. However, achieving these targets safely, without hypoglycemia, is challenging. With this study we evaluated glycemic control with fasting and pre-prandial BGs for patients using Glucommander Subcutaneous (GM SubQ) treatment for insulin therapy.

Methods

769 patients treated with GM SubQ insulin therapy were evaluated. Qualifying patients had two BGs >180 mg/dL in 24 hours and required insulin. The target glucose was set at 100-140 mg/dL fasting and pre-prandial. The safety and efficacy was evaluated at the following time points: before each meal (breakfast, lunch, dinner) and at bedtime via (1) BG averages, (2) BG reductions, and (3) hypoglycemic events <70 mg/dL and <40 mg/dL.

Results

Patients treated on GM SubQ achieved an average pre-prandial BG at breakfast of 119 mg/dL, lunch 131 mg/dL, dinner 126 mg/dL and bedtime of 116 mg/dL. Initial BG average was 227 mg/dL. BG average over length of stay was 132 mg/dL.

Reduction of BG at breakfast was 84 mg/dL, lunch 106 mg/dL, dinner 100 mg/dL, and bedtime 105 mg/ dL. Average BG reduction was 98.75 mg/dL. Hypoglycemia <70 mg/dL at breakfast was 2.3%, lunch 1.9%, dinner 3.0% and bedtime 2.0%. Hypoglycemia <40 mg/dL at breakfast was 0.0%, lunch 0.1%, dinner 0.1% and bedtime 0.1%.


Category Data
Patients 769
Initial BG Average 227 mg/dL
Glucommander BG Average 132 mg/dL
Hypoglycemia <70 mg/dL – Breakfast 2.3%
Hypoglycemia <70 mg/dL – Lunch 1.9%
Hypoglycemia <70 mg/dL – Dinner 3.0%
Hypoglycemia <70 mg/dL – Bedtime 2.0%
Hypoglycemia <40 mg/dL – Breakfast 0.0%
Hypoglycemia <40 mg/dL – Lunch 0.1%
Hypoglycemia <40 mg/dL – Dinner 0.1%
Hypoglycemia <40 mg/dL – Bedtime 0.1%

Conclusion

Patients using GM SubQ achieved prescribed glycemic target at each meal and bedtime with low incidence of hypoglycemia (<70 mg/dL & <40 mg/dL). These results suggest GM SubQ can maintain glucose control in ADA recommended targets without increased risk of hypoglycemia.

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