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Why Your Hospital Needs Patient-Specific Insulin Dosing, Not Just Personalized

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Dr. Paul Chidester, MD, FACP

Chief Medical Officer, Monarch Medical Technologies

When it comes to inpatient insulin management, precision is everything. The words “personalized” and “patient-specific” are often used interchangeably in healthcare, but when it comes to insulin dosing, the distinction is far more than semantics.

Understanding the difference could mean going from average and exceptional glycemic outcomes.

So, what’s the real difference? And why does it matter for your patients?

Personalized Insulin Dosing: A Limited View

Traditionally, “personalized” insulin dosing has referred to adjustments based on general parameters like a patient’s weight and recent glucose values.

While this is a step above fixed-dose or sliding-scale approaches, it still applies a one-size-fits-most logic to a highly complex physiological process.

This method:

  • Relies primarily on weight and past glucose readings
  • Requires the provider to predict the patient’s insulin sensitivity which can be incorrect, especially in patients with advanced age and/or renal insufficiency
  • Doesn’t fully account for dynamic, real-time patient factors
  • Often leads to overcorrection or underdosing, increasing risk for hypo- or hyperglycemia

In short, it personalizes based on broad traits, not the full clinical picture.

Patient-Specific Insulin Dosing: A Precision Approach

Patient-specific insulin dosing provided by EndoTool® goes further. It adapts dosing recommendations to the unique physiology and real-time condition of each patient, not just what’s on their chart from earlier that day.

This advanced approach uses up to 11 different clinical factors, including:

  • Renal function
  • Steroid use
  • Nutritional intake (e.g., tube feeds, TPN)
  • Diabetes Type
  • Mode of therapy

And uses these factors to continually calculate:

  • Insulin resistance and sensitivity
  • Residual circulating insulin (EREI)
  • A patient’s response to each insulin dose

By continuously analyzing these variables, our algorithm provides truly patient-specific insulin dosing that adapts to each patient’s unique needs, offering unmatched precision and safety.

Let’s Talk Features: Patient-Specific vs. Personalized Insulin Dosing

Category Personalized Dosing Patient-Specific Insulin Dosing Why is it important?
Calculation Method Based primarily on weight and prior glucose values Uses multiple patient-specific factors (e.g., renal function, steroids, residual insulin) More accurate dosing accounting for unique and evolving patient physiology, not just static factors
Therapy Adaptability No tailored support for specific clinical conditions Supports complex care scenarios (DKA, HHS, steroid-induced hyperglycemia) Enables clinicians to manage high-risk patients more effectively and timely
Safety Features General alerts, not based on patient physiology Real-time, scenario-specific warnings (e.g., hypoglycemia, hypokalemia) Increases patient safety using situation-specific alerts that guide faster, more appropriate interventions.
Carbohydrate Recommendations No specific carb guidance provided Suggests proactive, patient-specific carb doses to prevent/correct lows Helps prevent hypoglycemia before it happens, improving patient stability and reducing adverse events.
Adjustments in dosing model No change in the dosing model once the application is initiated The dosing model is continuously updated based on the patient’s response to insulin and changes in the clinical condition Supports dynamic, individualized treatment, which leads to better glucose control and faster recovery.

Why This Drives Better Care

For Patients:

  • Reduced Hypoglycemia: EndoTool patients experience severe hypoglycemia rates as low as 0.005%, thanks to precise adjustments based on current physiology.
  • Faster Stabilization: Patients reach target glucose ranges more efficiently and maintain them more consistently.
  • Better Outcomes: Improved glucose control has been linked to reduced adverse events and complications, and shorter hospital stays.

For Clinicians:

  • Less Manual Work: Automated calculations reduce cognitive load and eliminate guesswork for nurses and providers.
  • Increased Confidence: Clinicians trust that the system is making safe, data-driven recommendations tailored to their patient.
  • Fewer events and checks: Reduction in glucose checks and reduced hypoglycemia mean less stress for clinicians/patients and more efficient care.

Personalized Isn’t Enough: What’s Next?

In today’s hospital environment – where patient complexity is rising, and staff capacity is stretched, “good enough” insulin dosing just isn’t nearly good enough.

While personalized dosing offers a step beyond outdated sliding scale protocols, it still falls short of delivering the precision, safety, and efficiency to meet today’s care demands.

Patient-specific insulin dosing goes further, adapting in real time to each patient’s clinical status and reducing risks for both patients and providers.

If your hospital is serious about improving glucose management, reducing burnout, and delivering safer, smarter care—it’s time to think beyond personalized. It’s time to choose patient-specific insulin dosing.

Want to understand what makes EndoTool different? Get a Quick 15-minute Tour.

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.

About the author

Dr. Paul Chidester, MD, FACP | Chief Medical Officer, Monarch Medical Technologies

Dr. Paul Chidester is the Chief Medical Officer for Monarch Medical Technologies. After practicing for two decades as a nephrologist, he assumed a senior leadership role at Sentara Healthcare where he led the implementation of computerized insulin dosing software. He is involved with product development and customer engagement at Monarch Medical Technologies where the focus is to provide precision insulin dosing for patients. His key interest is working to further enhance this precision through the use of technologies such as CGM.

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