Comparison of a Computer-Based Intravenous Insulin Program with a Standard Paper Protocol in Terms of Safety and Efficacy in Management of DKA Patients in Community Hospitals: A Pilot Study


This retrospective analysis compares safety and efficacy of a standard paper protocol to a computer-based glucose management system (EndoTool) for patients admitted with diabetic ketoacidosis (DKA).


Cohort of six community hospitals

  • Mean time to a blood glucose <200 mg/dL was 287 minutes with EndoTool versus 336 minutes with a paper protocol.
  • Incidence of hypoglycemia was 0.00% of patients with EndoTool versus 10.0% of patients with a paper protocol.
  • Mean number of finger stick blood glucose readings per hour was 0.91 with EndoTool versus 0.99 with a paper protocol.
  • Nursing adherence to dosing recommendations was 100% with EndoTool versus 37% with a paper protocol.

With faster time to control, lower incidence of hypoglycemia and fewer finger sticks, a computer-based glucose management system (EndoTool) provides a safer, more simplified approach to intravenous insulin therapy than a paper protocol for patients admitted with DKA.


M. Raihan Azad; Sandra Hardee; Su-Fan Vanessa Lin; Robert Tanenberg.


Presented at American Association of Clinical Endocrinologists Scientific & Clinical Congress.