Glucotab-Based Basal-Bolus Insulin Therapy for Inpatient Glycemic Control Using Insulin Degludec

Guidelines recommend insulin therapy and the use of clinical decision support systems to manage hyperglycemia and diabetes mellitus in hospitalized patients. The aim of the study was to evaluate glycemic control using insulin degludec in an algorithm driven electronic decision support system in hospitalized patients with type 2 diabetes (T2D). The electronic decision support system GlucoTab® was applied for diabetes management in 30 hospitalized patients with T2D (18 women, age 74.1±10.9 years, HbA1c 71±23mmol/mol, BMI 28.6±5.6kg/m2, diabetes duration 14.9±15.1 years, creatinine 1.5±1.2mg/dl, length of hospital stay 9.1±4.0 days). Insulins degludec and aspart were used for basal-bolus insulin therapy. Blood glucose was tested four times daily using a point-of-care device integrated into the hospital information system. The overall mean blood glucose (BG) value was 144±53 mg/dl (mean pre-enrolment BG 211±84mg/dl). BG measurements were in 74.9% in the range of 70-<180 mg/dl. BG measurements in the ranges <40mg/dl, <70mg/dl, 180-<300 and ≥300mg/dl were observed in 0.0%, 1.5%, 22.9% and 0.7% of all measurements, respectively. Total daily insulin dose was 34.0±19.9 U (bolus insulin dose 18.7±13.1 U, basal insulin dose 16.0±7.9 U). Adherence to the algorithm-calculated total daily insulin dose was 93.2%; adherence to inject the algorithm-calculated basal and bolus insulin doses was high (99.0% and 85.3%). Basal-bolus therapy using GlucoTab® covered 80.8±19.9% of the patients’ total hospital stay. Glycemic control using insulin degludec in an algorithm driven electronic decision support system could safely be established in the hospital setting with high adherence to algorithm advice. Disclosure J. K. Mader: Advisory Panel; Self; Becton, Dickinson and Company, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Roche Diabetes Care, Speaker’s Bureau; Self; Abbott Diabetes, Novo Nordisk A/S, Roche Diabetes Care, Sanofi, Stock/Shareholder; Self; decide Clinical Software GmbH. T. Pieber: Advisory Panel; Self; ADOCIA, Arecor, AstraZeneca, Eli Lilly and Company, Novo Nordisk A/S, Sanofi, Research Support; Self; AstraZeneca, Novo Nordisk A/S. P. Beck: Employee; Self; decide Clinical Software GmbH, Stock/Shareholder; Self; decide Clinical Software GmbH. P. M. Baumann: None. F. Aberer: None. D. A. Hochfellner: None. A. Simic: None. L. Bytyqi: None. T. Poettler: None. B. Hoell: Employee; Self; decide Clinical Software GmbH. A. Fahrleitner-pammer: None. Funding Novo Nordisk