Tackling Euglycemic DKA: How EndoTool’s New Mode of Therapy Gives Hospitals a Critical Advantage

Hyperglycemic emergencies are becoming increasingly complex to treat, particularly with the rising incidence of Euglycemic Diabetic Ketoacidosis (EuDKA).

Often linked to the use of SGLT-2 inhibitors, EuDKA requires a treatment approach that traditional diabetic ketoacidosis (DKA) protocols were not designed to handle.

With FDA 510(k) clearance of EndoX 3, EndoTool IV now includes modes of therapy that supports insulin dosing recommendations for patients experiencing hyperglycemic crisis like EuDKA, Diabetic Ketoacidosis (DKA), and Hyperosmolar Hyperglycemic State (HHS).

This equips hospitals with a patient-specific, decision-support tool to meet the growing complexity of hyperglycemic emergencies.

Why is EuDKA a Growing Concern?

EuDKA shares the same underlying imbalances as DKA, notably, insufficient insulin activity and elevated glucagon levels driving ketone production and metabolic acidosis.

The difference is that glucose levels are often only moderately elevated, typically between 200 and 250 mg/dL.

This makes EuDKA easy to miss.

• Most common etiology today: SGLT-2 inhibitors, which promote glucosuria, lower insulin secretion, and increase glucagon release
• Other causative factors: Pregnancy, post-bariatric surgery, prolonged fasting, and acute illness
• At-risk patient groups: Both Type 1 and Type 2 diabetes patients, particularly those with latent autoimmune diabetes in adults (LADA)

Its subtle presentation requires a high index of suspicion, especially in acutely ill patients or those recovering from surgery who are on or have recently discontinued SGLT-2 inhibitors.

How EndoTool’s EndoX 3 Mode Redefines Care for Euglycemic DKA

Treating EuDKA requires simultaneous insulin administration and glucose supplementation to maintain target glucose levels while resolving acidosis. EndoX 3 is built to address this challenge by providing dose recommendations for glycemic control.

• Optimized Targeting: EndoTool titrates insulin within a higher glucose range, typically 200 to 250 mg/dL, ensuring the metabolic acidosis has resolved and preventing premature discontinuation of the infusion.
• Built-in Safety Advisories: If glucose falls below the set threshold, EndoTool alerts the nurse to increase dextrose infusion, helping sustain insulin therapy and prevent treatment interruptions.
• Closing the Loop on Resolution: The system prompts the clinician to ensure resolution of the anion gap or beta-hydroxybutyrate clearance before adjusting to a standard target range minimizing recurrence of hyperglycemic crisis like EuDKA, DKA, and HHS.

By integrating real-time glucose values, renal function, and estimated residual insulin, EndoTool delivers patient-specific recommendations that support safe and timely therapy.

Innovative Support for Today’s Inpatient Demands

EndoX 3 is not a static protocol. This mode of therapy is:

• FDA-cleared for insulin dosing recommendations for glycemic control
• Designed to support clinicians in anticipating and mitigating common pitfalls in insulin dosing decisions, and
• Proven to support nurse efficiency and safety

This positions EndoTool as a critical clinical decision support for hospitals seeking to improve safety, streamline care, and achieve better outcomes in the management of complex hyperglycemic emergencies.

The Benefits Across the Care Continuum

EndoTool’s EndoX3 mode is designed to deliver value at every level of care – optimizing outcomes for patients, easing decision-making for providers and nurses, and strengthening outcomes and resource utilization for hospitals and administrators.

For Patients:

1. Tailors Dosing: EndoTool accounts for glucose, renal function, and residual insulin to provide patient-specific dosing during hyperglycemic crises like EuDKA, DKA, and HHS.
2. Reduced risk of complications from under-treatment or premature withdrawal of insulin therapy
3. Faster recovery times with protocols that resolve acidosis more reliably

For Providers and Nurses:

1. Decision support at the bedside: Patient-specific dosing recommendations reduce guesswork
2. Built-in safety alerts: Proactive notifications to maintain insulin therapy and prevent hypoglycemia
3. Improved workflow efficiency: Supports streamlined care, fewer interruptions, and greater confidence in managing a complex condition

For Hospitals and Administrators:

1. FDA-cleared solution for managing hyperglycemic crisis like EuDKA, DKA, and HHS where EuDKA is an increasing complication arising from the more frequent use of SGLT-2 inhibitors.
2. Operational efficiency: Reduces variation in care, standardizes treatment, and supports nurse efficiency
3. Reputation and preparedness: Demonstrates proactive readiness for complex hyperglycemic emergencies

Staying Ahead of Emerging Hyperglycemic Challenges

Euglycemic DKA may not present with extreme glucose levels, but its risks are significant. EndoTool IV’s EndoX3 Mode of Therapy equips clinicians with a tailored tool to navigate its nuances and deliver consistent, effective care.

Hospitals adopting EndoTool can be confident they are ready to meet this growing challenge while reinforcing their commitment to the highest standards of patient safety.

EndoTool is a decision support tool intended to assist trained healthcare professionals in intravenous insulin dosing. It does not replace clinical judgment or serve as a primary treatment protocol.

About EndoTool

Made by Monarch Medical Technologies, EndoTool is the only patient-specific insulin dosing system which simplifies the complex task of glycemic management in hospital environments. The recommended dosing is different for each patient based on multiple clinical characteristics. The FDA-cleared platform is utilized in hundreds of hospitals across the United States and is fully integrated with all major electronic medical records. To see how EndoTool can support your health system, get in touch today.