title: [Management of inpatient glucose in non-critical care setting: impact of a proactive intervention based on a point-of-care of system with remote viewing of capillary blood glucose].
abstract: OBJECTIVE
  The management of hyperglycemia in conventional wards is suboptimal. The objective of our study was to evaluate the efficacy of a proactive intervention supported by point-of-care system with remote viewing of capillary blood glucose (CBG) on glycemic control as compared to usual care in non-critical surgical patients.
  
  
  METHODS
  Two sequential periods of 2 months were defined. In the first phase (control, CPh), in which the surgical team was in charge of glycemic control, capillary glucose levels were recorded by StatStrip(®) system, and endocrinological support was provided upon surgeons request. In a second phase (intervention, IPh), the endocrinologist proceeded based on remotely-viewed CBG values. We compared the use of basal-bolus therapy and the degree of glycemic control between the 2 study periods.
  
  
  RESULTS
  The IPh was associated with greater use of basal-bolus regimens (21.4 vs. 58.3%; P=.003). The average CBG during the CPh was 161 ± 64 vs. 142 ± 48 mg/dL during the IPh (P<.001). The IPh was associated with an increased frequency of CBG determinations between 70-140 mg/dL (CPh: 41.8 vs. IPh: 52.5%; P<.001), lower frequency of ≥ 250 mg/dL CBG determinations (CPh: 9 vs. IPh: 3.5%; P<.001), with no increase in the frequency of hypoglycemia (CPh: 3 vs. IPh: 3.7%; P=.39).
  
  
  CONCLUSIONS
  A proactive endocrine intervention facilitated by a point-of-care system with remote viewing of CBG is associated with improved glycemic control in non-critical patients, without any further increase in the number of hypoglycaemic recordings.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari, Barcelona, España; Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Amor
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari, Barcelona, España; Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Paola A
authors.initials: PA
authors.lastname: Ríos
authors.affiliation: Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Graupera
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari, Barcelona, España; Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Conget
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari, Barcelona, España; Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Enric
authors.initials: E
authors.lastname: Esmatjes
authors.affiliation: Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Comallonga
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari, Barcelona, España; Instituto de Enfermedades Digestivas y Metabólicas, Hospital Clínic i Universitari, Barcelona, España. Electronic address: jovidal@clinic.ub.es.
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis* / Q000378:metabolism; D002196:Capillaries; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000379:methods*; D019095:Point-of-Care Systems; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Abordaje de la glucemia intrahospitalaria; Basal-bolus insulin therapy; Inpatient glucose management; Non-critical patient; Paciente no-crítico; Pauta basal-bolo; Point-of-care