Literature DB >> 19885202

Safety and effectiveness of a computerized subcutaneous insulin program to treat inpatient hyperglycemia.

Rattan Juneja1, Adam A Golas, Joni Carroll, Deborah Nelson, Victor J Abad, Corbin P Roudebush, Samuel J Flanders.   

Abstract

BACKGROUND: This proof of concept study was designed to evaluate the safety and effectiveness of a computerized insulin program, the Clarian GlucoStabilizer Subcutaneous Insulin Program (CGS-SQ). This paper discusses the CGS-SQ's impact on the glycemic control of hospitalized patients with hyperglycemia.
METHODS: Patients at Methodist and Indiana University Hospitals requiring subcutaneous insulin were treated using the CGS-SQ. This program calculates subcutaneous bolus insulin doses based on the current blood glucose (BG), using an insulin sensitivity factor, the number of grams of carbohydrates eaten, and an insulin-to-carbohydrate ratio, with a goal of maintaining the patient's BG in a prespecified target range. The target range, insulin sensitivity factor, and insulin-to-carbohydrate ratio are established by the physician.
RESULTS: From April 2006 to September 2007, the CGS-SQ treated 1772 patients at Methodist and Indiana University Hospitals, with 46,575 BGs in its database. For these patients, the average BG was 158.3 mg/dl, 40.5% percent of BGs were in the default target range of 100-150 mg/dl, and 69.8% were in the wider range of 70-180 mg/dl. The hypoglycemia (BG <40 mg/dl) rate was 0.18%.
CONCLUSIONS: The CGS-SQ provided a means to deliver insulin in a standardized manner, resulting in satisfactory BG control with a low hypoglycemia rate, thus serving as a tool for safe and effective insulin therapy for hospitalized patients.

Entities:  

Keywords:  computers; diabetes; dosing; hyperglycemia; insulin; protocol; subcutaneous

Year:  2008        PMID: 19885202      PMCID: PMC2769747          DOI: 10.1177/193229680800200307

Source DB:  PubMed          Journal:  J Diabetes Sci Technol        ISSN: 1932-2968


  9 in total

1.  Intensive insulin therapy in critically ill patients.

Authors:  G van den Berghe; P Wouters; F Weekers; C Verwaest; F Bruyninckx; M Schetz; D Vlasselaers; P Ferdinande; P Lauwers; R Bouillon
Journal:  N Engl J Med       Date:  2001-11-08       Impact factor: 91.245

2.  Glucose control lowers the risk of wound infection in diabetics after open heart operations.

Authors:  K J Zerr; A P Furnary; G L Grunkemeier; S Bookin; V Kanhere; A Starr
Journal:  Ann Thorac Surg       Date:  1997-02       Impact factor: 4.330

3.  Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures.

Authors:  A P Furnary; K J Zerr; G L Grunkemeier; A Starr
Journal:  Ann Thorac Surg       Date:  1999-02       Impact factor: 4.330

Review 4.  Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview.

Authors:  S E Capes; D Hunt; K Malmberg; H C Gerstein
Journal:  Lancet       Date:  2000-03-04       Impact factor: 79.321

5.  Intensive insulin therapy protects the endothelium of critically ill patients.

Authors:  Lies Langouche; Ilse Vanhorebeek; Dirk Vlasselaers; Sarah Vander Perre; Pieter J Wouters; Kristin Skogstrand; Troels K Hansen; Greet Van den Berghe
Journal:  J Clin Invest       Date:  2005-08       Impact factor: 14.808

Review 6.  Tight control of glycaemia in critically ill patients.

Authors:  Jean-Charles Preiser; Philippe Devos; Greet Van den Berghe
Journal:  Curr Opin Clin Nutr Metab Care       Date:  2002-09       Impact factor: 4.294

7.  Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events.

Authors:  Harold L Lazar; Stuart R Chipkin; Carmel A Fitzgerald; Yusheng Bao; Howard Cabral; Carl S Apstein
Journal:  Circulation       Date:  2004-03-08       Impact factor: 29.690

8.  Utilization of a computerized intravenous insulin infusion program to control blood glucose in the intensive care unit.

Authors:  Rattan Juneja; Corbin Roudebush; Nilay Kumar; Angela Macy; Adam Golas; Donna Wall; Cheryl Wolverton; Deborah Nelson; Joni Carroll; Samuel J Flanders
Journal:  Diabetes Technol Ther       Date:  2007-06       Impact factor: 6.118

9.  Effect of an intensive glucose management protocol on the mortality of critically ill adult patients.

Authors:  James Stephen Krinsley
Journal:  Mayo Clin Proc       Date:  2004-08       Impact factor: 7.616

  9 in total
  5 in total

Review 1.  Subcutaneous Insulin Dosing Calculators for Inpatient Glucose Control.

Authors:  Jagdeesh Ullal; Joseph A Aloi
Journal:  Curr Diab Rep       Date:  2019-11-04       Impact factor: 4.810

2.  A MULTICENTER STUDY EVALUATING PERCEPTIONS AND KNOWLEDGE OF INPATIENT GLYCEMIC CONTROL AMONG RESIDENT PHYSICIANS: ANALYZING THEMES TO INFORM AND IMPROVE CARE.

Authors:  William B Horton; Sidney Law; Monika Darji; Mark R Conaway; Mikhail Y Akbashev; Nancy T Kubiak; Jennifer L Kirby; S Calvin Thigpen
Journal:  Endocr Pract       Date:  2019-08-14       Impact factor: 3.443

Review 3.  Medical software applications for in-hospital insulin therapy: A systematic review.

Authors:  Julia Mandaro Lavinas Jones; Alina Coutinho Rodrigues Feitosa; Malena Costa Hita; Elisabeth Martinez Fonseca; Rodrigo Braga Pato; Marcos Tadashi Kakitani Toyoshima
Journal:  Digit Health       Date:  2020-12-26

Review 4.  Improving glycemic control in critically ill patients: personalized care to mimic the endocrine pancreas.

Authors:  J Geoffrey Chase; Thomas Desaive; Julien Bohe; Miriam Cnop; Christophe De Block; Jan Gunst; Roman Hovorka; Pierre Kalfon; James Krinsley; Eric Renard; Jean-Charles Preiser
Journal:  Crit Care       Date:  2018-08-02       Impact factor: 9.097

5.  Pathophysiologic Signature of Impending ICU Hypoglycemia in Bedside Monitoring and Electronic Health Record Data: Model Development and External Validation.

Authors:  William B Horton; Andrew J Barros; Robert T Andris; Matthew T Clark; J Randall Moorman
Journal:  Crit Care Med       Date:  2022-03-01       Impact factor: 7.598

  5 in total

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