Objective

This study compares glycemic outcomes before and after implementation of glycemic control software (EndoTool) for patients receiving intravenous insulin, all of whom were previously treated using a paper algorithm.

Setting

71-bed full-service community hospital.

Results

• Incidence of hypoglycemia <70 mg/dL decreased 80% with EndoTool, from 4% to 0.8% of blood glucose readings.
• Incidence of hyperglycemia >200 mg/dL decreased 53.8% with EndoTool, from 26% to 12% of blood glucose readings.
• Mean glucose housewide decreased 21.7 mg/dL with EndoTool, from 183.9 to 162.2 mg/dL, while mean glucose within intensive care units decreased 20.1 mg/dL with EndoTool, from 184.1 to 147.1 mg/dL, achieving top performer status in the Remote Automated Laboratory System (RAL) benchmarking program.
• Average time to achieve two consecutive blood glucose readings <150 mg/dL was 4.8 hours with EndoTool.
• Average length of stay for DKA patients decreased from 3.3 to 2.66 days with EndoTool, representing an estimated $3,615.16 cost savings per patient and $74,932.41 cost savings per year.

Conclusions

Use of glycemic control software (EndoTool) allows better and more rapid glucose control than a paper algorithm and, according to physicians and nurses, makes transitioning from intravenous to subcutaneous insulin much easier.