title: Standardized Glycemic Management with a Computerized Workflow and Decision Support System for Hospitalized Patients with Type 2 Diabetes on Different Wards.
abstract: BACKGROUND
  This study investigated the efficacy, safety, and usability of standardized glycemic management by a computerized decision support system for non-critically ill hospitalized patients with type 2 diabetes on four different wards.
  
  
  METHODS
  In this open, noncontrolled intervention study, glycemic management of 99 patients with type 2 diabetes (62% acute admissions; 41 females; age, 67±11 years; hemoglobin A1c, 65±21 mmol/mol; body mass index, 30.4±6.5 kg/m(2)) on clinical wards (Cardiology, Endocrinology, Nephrology, Plastic Surgery) of a tertiary-care hospital was guided by GlucoTab(®) (Joanneum Research GmbH [Graz, Austria] and Medical University of Graz [Graz, Austria]), a mobile decision support system providing automated workflow support and suggestions for insulin dosing to nurses and physicians.
  
  
  RESULTS
  Adherence to insulin dosing suggestions was high (96.5% bolus, 96.7% basal). The primary outcome measure, percentage of blood glucose (BG) measurements in the range of 70-140 mg/dL, occurred in 50.2±22.2% of all measurements. The overall mean BG level was 154±35 mg/dL. BG measurements in the ranges of 60-70 mg/dL, 40-60 mg/dL, and <40 mg/dL occurred in 1.4%, 0.5%, and 0.0% of all measurements, respectively. A regression analysis showed that acute admission to the Cardiology Ward (+30 mg/dL) and preexisting home insulin therapy (+26 mg/dL) had the strongest impact on mean BG. Acute admission to other wards had minor effects (+4 mg/dL). Ninety-one percent of the healthcare professionals felt confident with GlucoTab, and 89% believed in its practicality and 80% in its ability to prevent medication errors.
  
  
  CONCLUSIONS
  An efficacious, safe, and user-accepted implementation of GlucoTab was demonstrated. However, for optimized personalized patient care, further algorithm modifications are required.
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Neubauer
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Julia K
authors.initials: JK
authors.lastname: Mader
authors.affiliation: 2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Bernhard
authors.initials: B
authors.lastname: Höll
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Felix
authors.initials: F
authors.lastname: Aberer
authors.affiliation: 2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Klaus
authors.initials: K
authors.lastname: Donsa
authors.affiliation: 2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Thomas
authors.initials: T
authors.lastname: Augustin
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Lukas
authors.initials: L
authors.lastname: Schaupp
authors.affiliation: 2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Stephan
authors.initials: S
authors.lastname: Spat
authors.affiliation: 2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Peter
authors.initials: P
authors.lastname: Beck
authors.affiliation: 3 Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Friedrich M
authors.initials: FM
authors.lastname: Fruhwald
authors.affiliation: 4 Division of Nephrology, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Christian
authors.initials: C
authors.lastname: Schnedl
authors.affiliation: 4 Division of Nephrology, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rosenkranz
authors.affiliation: 5 Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz , Graz, Austria .
authors.forename: David B
authors.initials: DB
authors.lastname: Lumenta
authors.affiliation: 5 Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz , Graz, Austria .
authors.forename: Lars-Peter
authors.initials: LP
authors.lastname: Kamolz
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .
authors.forename: Johannes
authors.initials: J
authors.lastname: Plank
authors.affiliation: 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz , Graz, Austria .|2 Joanneum Research GmbH, HEALTH, Institute for Biomedicine and Health Sciences , Graz, Austria .
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
mesh_terms: D000368:Aged; D000465:Algorithms; D001317:Austria; D001786:Blood Glucose / Q000032:analysis*; D020000:Decision Support Systems, Clinical; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007297:Inpatients; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012984:Software; D057188:Workflow
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin