Raymie McFarland Discusses Findings From Glytec's Basal-Bolus Insulin Study

Raymie McFarland Discusses Findings From Glytec's Basal-Bolus Insulin Study

Glytec’s eGlycemic Management System (eGMS) helped the Kaweah Delta hospital shift its standard of care to basal-bolus insulin, explained Raymie McFarland, vice president of Quality Initiatives at Glytec. Basal-bolus is considered best practice and is safer for patients, but many hospitals have not adopted it due to its difficulty. Glytec hopes its eGMS can change that.

News Site:  AJMC.com
Date:  June 21, 2017

Transcript (slightly modified)

Can you discuss the Kaweah Delta findings being presented at the ADA Scientific Sessions?

The poster that’s being presented is a case study looking at a 500-plus bed hospital in the San Joaquin Valley of California. It’s a facility named Kaweah Delta Regional Medical Center. Kaweah Delta is a very interesting case in that they did not have expertise from an endocrinology standpoint either in or outside the hospital or the health system facilities.

Kaweah Delta was a practice in the past that used a lot of sliding-scale, and the evidence that’s being presented is really looking at everything from improved education; a change in their order sets; full adoption of our eGMS, our eGlycemic Management System, with Glucommander running both IV, transition, and sub-Q [subcutaneuous] orders and management of all their insulin.

Why is it important to follow best practices around basal-bolus insulin?

Over 10 years ago, AACE (American Association of Clinical Endocrinologists) and ADA both recommended to move away, for practitioners and hospitals, to move away from sliding-scale to basal-bolus. In fact, there were several articles written by the name of RABBIT and RABBIT Surgery by Dr. Guillermo Umpierrez that really focused on the move from sliding-scale to basal-bolus, that really proved that it was more efficacious and better for patients, reduced hypoglycemia and such, so better safety.

At Kaweah Delta, they used sliding-scale over 95% of the time, so a majority of their practice was using what we would consider an old practice, but really it’s what’s used in most hospitals today.

Why aren’t best practices regarding sliding-scale vs. basal-bolus insulin being followed?

Sliding-scale insulin in the hospital setting is easy. It’s very easy to write the order and walk away. Basal-bolus insulin management with correction is very difficult, it’s cumbersome, it’s something that a provider has to go in every day and make a change to. So the adoption of basal-bolus, even though it is best practice and it’s what’s best for patients, isn’t something that we see widely used across the hospitals.

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