title: Blood glucose control using a computer-guided glucose management system in allogeneic hematopoietic cell transplant recipients.
abstract: Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment for patients with hematological malignancies. However, is associated with substantial rates of morbidity and mortality. We and others have shown that malglycemia is associated with adverse transplant outcome. Therefore, improving glycemic control may improve transplant outcome. In this prospective study we evaluated the feasibility of using Glucommander (a Computer-Guided Glucose Management System; CGGM) in order to achieve improved glucose control in hospitalized HCT patients. Nineteen adult patients contributed 21 separate instances on CGGM. Patients were on CGGM for a median of 43 h. Median initial blood glucose (BG) on CGGM was 244 mg/dL, and patients on 20 study instances reached the study BG target of 100-140 mg/dL after a median of 6 h. After BG reached the target range, the median average BG level per patient was 124 mg/dL. Six patients had a total of 10 events of BG <70 mg/dL (0.9% of BG measurements), and no patients experienced BG level <40 mg/dL. The total estimated duration of BG <70 mg/dL was 3 h (0.2% of the total CGGM time). In conclusion, our study demonstrates that stringent BG control in HCT patients using CGGM is feasible.
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Espina
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: I
authors.initials: I
authors.lastname: Jenkins
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Taylor
authors.affiliation: UPMC Cancer Center, Pittsburgh, PA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Farah
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Cho
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Epworth
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Coleman
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Pinelli
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Mentzer
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Jarrett
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Gooley
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Massachusetts General Hospital Cancer Center, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: O'Donnell
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.
authors.forename: I B
authors.initials: IB
authors.lastname: Hirsch
authors.affiliation: Internal Medicine, University of Washington, Seattle, WA, USA.|Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Bar
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000209:etiology; D004360:Drug Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin