WALTHAM, Mass.–A prospective quality improvement study led by Eastern Virginia Medical School and presented at the 17th Annual Diabetes Technology Meeting highlights the importance of properly managing transitions of care for patients with diabetes. The study observed that when providers used the Hospital-to-Home (H2H®) module of Glytec’s eGlycemic Management System® to guide insulin regimens prescribed at discharge, patients had no diabetes-related readmissions, urgent care visits or emergency department visits within the first 30 days.
“For patients with diabetes, laying a foundation for optimal recovery and well-being following hospitalization means we need to give appropriate consideration to insulin regimens prescribed at discharge,” says the study’s principal investigator, Dr. Jagdeesh Ullal, associate professor at Eastern Virginia Medical School and endocrinologist at Sentara Healthcare. “Many variables factor in to the equation: the treatments patients receive during their stay, new diagnoses or medications, their blood sugar levels and insulin sensitivities. Understandably, this can be challenging for physicians who don’t practice in the field of endocrinology, which is why so many patients with diabetes are discharged home with no change to the insulin regimen they were on prior to hospitalization. The study suggests that an evidence-based software solution like Glytec’s can help overcome this inertia and be of great value.”
A total of 28 patients with diabetes were enrolled in the study. All had an admission A1C greater than 6.5%, with the average at 9.5%, which means their diabetes prior to hospitalization was poorly controlled. The average admission blood glucose among these patients was 223 mg/dL, or 43 mg/dL above the acceptable range. Study sites included Sentara Norfolk General Hospital, Sentara Virginia Beach General Hospital and Sentara Northern Virginia Medical Center.
Insulin administered during hospitalization, whether intravenous and/or subcutaneous, was managed using the Glucommander™ module of Glytec’s eGlycemic Management System®, an FDA-cleared software-as-a-service solution that provides personalized dosing recommendations and is integrated with the EMR. The average daily blood glucose among patients enrolled in the study was 152 mg/dL, a reduction of 71 mg/dL, or 32%, from the average admission blood glucose and well below mid-point of the goal range (140-180 mg/dL).
“Sentara Healthcare is accustomed to seeing excellent results using Glytec’s software, as many prior studies have showcased. Over the past several years, our data has demonstrated that with Glucommander™, we’re able to get hospitalized patients into a prescribed target glucose range very quickly, and we’re able to keep them there for the duration of their stay, with very low rates of hyperglycemia, hypoglycemia and other complications,” says one of the study’s authors, Dr. Paul Chidester, Vice President of Medical Affairs at Sentara Norfolk General Hospital. “With this latest research, however, we were able to examine what happens to patients after discharge. We know based on current literature that 30-day readmission rates among patients with diabetes are 20% higher than patients without diabetes, but using Glytec’s H2H® module, we had no study patients who were readmitted within 30 days due to their diabetes.”
After patients enrolled in the study were discharged, certified diabetes educators called them once every seven days for the first month to check on the status of their diabetes as well as their use of healthcare resources. Over this period, given the prescribed home insulin regimen guided by Glytec’s H2H® module, none of the patients had a readmission, urgent care visit or emergency department visit due to their diabetes or any glucose-related cause, and only one had an episode of severe hypoglycemia <40 mg/dL.
Raymie McFarland, Vice President of Quality Initiatives at Glytec, adds: “Caring for patients both in and out of the hospital is crucial to creating high-reliability organizations. It’s the cornerstone of population health and it’s a commitment healthcare providers need to make to the communities they serve. Innovative solutions like Glytec’s H2H® can help them achieve those goals.”
Founded in 2006, Glytec is the pioneer and leader in diabetes therapy management software and medication optimization, enabling healthcare organizations to achieve best practices for glucose control. The company’s comprehensive eGlycemic Management System® (eGMS®) has been proven to dramatically reduce the drivers of cost and clinical variation, including hypoglycemia and hyperglycemia; A1C levels; adverse drug events; mortality; length of stay; unnecessary admissions, readmissions and ED visits; and patient discontinuation of insulin therapy. eGMS® centers on an FDA-cleared insulin dosing solution that supports personalized intravenous and subcutaneous therapy for adult and pediatric populations. Its efficacy and safety have been validated by more than 60 research studies. eGMS® integrates seamlessly with EMR and connected device systems for streamlined use across the entire continuum of care, including at-home, provider-directed care managed through telehealth, population health and other value-based programs. The company’s cloud-hosted software-as-a-service (SaaS) delivery model allows for rapid implementation and anytime, anywhere access. Glytec has offices in Waltham, Massachusetts and Greenville, South Carolina. For more information, visit www.glytecsystems.com.
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