We’ve Joined Glooko to Advance Diabetes Care. → Read more
Clinical Evidence
Temple Health Achieves Zero Severe Hypoglycemia in Renally Impaired Patients with EndoTool SubQ
Objective
To evaluate the safety and efficacy of the EndoTool SubQ (ETSQ) insulin dosing application for subcutaneous (SQ) insulin administration in hospitalized patients, and to compare clinical outcomes against those treated using a standard insulin order set. The analysis also examined performance in high-risk patients with advanced renal impairment.
Method
This retrospective analysis included patients admitted to Temple Health Academic Medical Center between January and June 2025 who required subcutaneous insulin for blood glucose control.
Treating physicians elected to either initiate insulin dosing using the EndoTool SubQ (ETSQ) computerized application or a standard insulin order set.
Outcomes measured included:
- Severe hypoglycemia (<40 mg/dL)
- Severe hyperglycemia (>300 mg/dL)
A subgroup analysis was performed in patients with estimated glomerular filtration rate (eGFR) <10 mL/min, calculated using the Levey formula (Ann Intern Med. 2009;150:604–612).
Key Evaluation Areas
| Evaluation Area | Details |
|---|---|
| Patients Treated with ETSQ | 2,069 |
| Patients Treated with Standard Order Set | 949 |
| Subgroup | 47 ETSQ-treated patients with eGFR <10 mL/min |
| Primary Outcomes Measured | Severe Hypoglycemia (<40 mg/dL), Severe Hyperglycemia (>300 mg/dL) |
Results
| Outcome | ETSQ | Standard Order Set | p-value / Impact |
|---|---|---|---|
| Severe Hypoglycemia (<40 mg/dL) | 0.071% | 0.206% | p < 0.0001 (66% reduction) |
| Severe Hyperglycemia (>300 mg/dL) | 3.25% | 4.74% | p < 0.0001 (26% reduction) |
| eGFR <10 mL/min Subgroup (n=47) | 0.0% Hypoglycemia, 6.14% Hyperglycemia |
Data not available | Demonstrated safety in high-risk renal patients |
Conclusion
Use of a computerized, patient-specific subcutaneous insulin dosing application (EndoTool SubQ) was associated with significant reductions in both severe hypoglycemia and hyperglycemia compared to standard insulin order sets.
The system demonstrated safe and effective use in patients with advanced renal failure, with zero incidence of severe hypoglycemia in this high-risk group.
References
Authors
Ajay Rao, MD, MMSc; David Fleece, MD; Paul D. Chidester, MD, FACP; Anderson Schrader, MEng
Source
Presented at the Diabetes Technology Meeting (DTM), 2025
Temple University Health System and Lewis Katz School of Medicine at Temple University
Year
2025
Related posts
Clinical Evidence
Improving Inpatient Glycemic Safety at Temple Health with EndoTool SubQ
Improving Inpatient Glycemic Safety at Temple Health with EndoTool SubQ
Temple Health, a 3-hospital academic system was experiencing high rates of hypoglycemia due to reliance on sliding scale insulin (SSI). To improve safety and align with ADA guidelines, the hospital implemented EndoTool SubQ, a patient-specific insulin dosing software the supports four dosing protocols, including basal-bolus-correction (BBC).
Clinical Evidence
How Corewell Health Reduced LOS for DKA Patients, Slashing Costs by Almost $1M
How Corewell Health Reduced LOS for DKA Patients, Slashing Costs by Almost $1M
The objective of this study was to evaluate the impact of EndoTool IV insulin dosing software on mortality, length of stay, readmission rates, and cost of care for patients treated for Diabetic Ketoacidosis (DKA) at Corewell Health West.
Clinical Evidence
Using EndoTool to Optimize Insulin Management in DKA Patients with Renal Impairment
Using EndoTool to Optimize Insulin Management in DKA Patients with Renal Impairment
The objective of this study was to evaluate the impact of renal insufficiency on hypoglycemia rates in patients treated for Diabetic Ketoacidosis (DKA) utilizing a computerized insulin dosing algorithm.
Get in Touch
Ready to get started?
Fill in your details and one of our friendly team members will be in touch to show you how easily EndoTool can support your hospital.
"*" indicates required fields
