Retrospective Analysis Produced by Monarch Medical Technologies Explores Effect of Blood Glucose Goal Range and Two-Hour Blood Glucose Checks on Hypoglycemia Incidence

Two posters presented at AACE 2019 review the safety and efficacy of blood glucose goal range and two-hour blood glucose checks for intravenous insulin dosing.

Monarch Medical Technologies, the leader in precision insulin dosing technology for optimized glycemic management, presented two posters at the American Association of Clinical Endocrinologists (AACE) Annual Meeting. The two retrospective studies analyze a database of nearly one million blood glucose readings from approximately 45,000 patients who were prescribed intravenous (IV) insulin dose recommendations using the EndoTool Glucose Management System.

The first poster, “Measure of Safety for Q2Hour vs. Q1Hour Glucose Checks for Intravenous Insulin Dosing,” aimed to determine the safety and efficacy of two-hour blood glucose checks when using the electronic glucose management system (eGMS), EndoTool.

Many paper protocols and eGMS dosing algorithms for IV insulin make recommendations to change from hourly (q1hour) blood glucose checks to every two-hour (q2hour) checks based on various measures of the subject’s blood glucose stability. However, it is suggested that the algorithms should be evaluated based on the incidence of hypoglycemia and variability. This analysis found that measures of hypoglycemia and control were superior for q2hour checks compared to q1hour checks, confirming that the EndoTool algorithm for recommendation of q2hour checks is appropriate.

“The ability to move to q2hour blood glucose checks benefits the patient and significantly improves nursing workflow and the cost of care,” said Laurel Fuqua, Executive VP and Chief Clinical Officer of Monarch Medical Technologies. “However, this transition must be made at the appropriate time to ensure patient safety. This study confirms that the EndoTool algorithm is appropriate and safe in its recommendation.”

The second poster, “Goal Range Effect on Hypoglycemia Incidence for Intravenous Insulin Dosing,” examined the effect of goal range on the incidence of hypoglycemia in patients receiving intravenous insulin therapy.

Most eGMS and paper protocols require users to set an upper goal and lower goal, referred to as the goal range. Target blood glucose values for the glucose range vary, and limited research exists to study the effect of goal range on hypoglycemia. This retrospective analysis stratified two goal ranges, 100 to 140 mg/dL and 160 to 200 mg/dL, and analyzed the incidence of hypoglycemia in sub-ranges of 10 mg/dL. The analysis concluded that as the upper goal is lowered, reducing the spread of the goal range has the potential to reduce hypoglycemia.

“While the EndoTool algorithm has statistically eliminated hypoglycemia, we continue to look for enhancements to completely eliminate the risk of hypoglycemia,” said W. Patrick Burgess, Founder and Inventor of EndoTool. “Further research is required; however, our analysis supported the hypothesis that reducing the goal range spread as the upper goal is lowered could make a significant difference in reducing hypoglycemia.”

About Monarch Medical Technologies

Monarch Medical Technologies is the leading provider of electronic systems for inpatient glycemic management. Monarch’s EndoTool Glucose Management System offers personalized dosing recommendations for intravenous and subcutaneous insulin therapy. As a Class II FDA-cleared, patented software suite, EndoTool has been chosen by more than 300 hospitals to provide unsurpassed patient-specific glycemic control across a broad population of patients, and ultimately deliver better, safer care. For more information, please visit