Safety and effectiveness of a computerized subcutaneous insulin program to treat inpatient hyperglycemia.
BACKGROUND
This proof of concept study was designed to evaluate the safety and effectiveness of a computerized insulin program, the Clarian GlucoStabilizer Subcutaneous Insulin Program (CGS-SQ). This paper discusses the CGS-SQ's impact on the glycemic control of hospitalized patients with hyperglycemia.


METHODS
Patients at Methodist and Indiana University Hospitals requiring subcutaneous insulin were treated using the CGS-SQ. This program calculates subcutaneous bolus insulin doses based on the current blood glucose (BG), using an insulin sensitivity factor, the number of grams of carbohydrates eaten, and an insulin-to-carbohydrate ratio, with a goal of maintaining the patient's BG in a prespecified target range. The target range, insulin sensitivity factor, and insulin-to-carbohydrate ratio are established by the physician.


RESULTS
From April 2006 to September 2007, the CGS-SQ treated 1772 patients at Methodist and Indiana University Hospitals, with 46,575 BGs in its database. For these patients, the average BG was 158.3 mg/dl, 40.5% percent of BGs were in the default target range of 100-150 mg/dl, and 69.8% were in the wider range of 70-180 mg/dl. The hypoglycemia (BG <40 mg/dl) rate was 0.18%.


CONCLUSIONS
The CGS-SQ provided a means to deliver insulin in a standardized manner, resulting in satisfactory BG control with a low hypoglycemia rate, thus serving as a tool for safe and effective insulin therapy for hospitalized patients.
Juneja
Rattan
R
Division of Endocrinology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. rajuneja@iupui.edu
Golas
Adam A
AA
Carroll
Joni
J
Nelson
Deborah
D
Abad
Victor J
VJ
Roudebush
Corbin P
CP
Flanders
Samuel J
SJ