Introduction: Achieving inpatient glycemic control remains challenging. To meet this challenge, 3 years ago we implemented system wide use of our SQIA for patients who were NPO, on continuous tube feeds (TF), or on total parenteral nutrition (TPN). We previously showed in year 1, the number of orders a physician had to place while a patient was on the SQIA was reduced by a factor of more than 12, when compared with while a patient was on conventional insulin (CI) dosing. We now report the glycemic results from the first 3 years.
Methods: Our retrospective cross-sectional analysis at UCSF from 9/3/2020 to 9/2/2023 compares glucose measurements in adult, non-OB inpatients who were NPO, on TF, or on TPN and ordered for SQIA versus conventional physician-driven insulin adjustments. The 3-year study interval was divided into 3 periods defined by the dates of major optimization updates to the algorithm and programming. The ordering physicians were free to assign patients to SQIA or conventional insulin orders. We used Poisson regression with number of glucose measurements as the offset.
Results: Table 1
Conclusion: Selected now for 80% of eligible hospitalizations, SQIA, compared to CI, was associated with decreased hypoglycemia without an increase in hyperglycemia. With the SQIA, glucose improvements have continued while dramatically reducing burden for rewriting orders.
G. Lee: None. M.A. Kohn: None. E. Rov-Ikpah: None. P. Mehta: None. C. San Luis: None. C. Johnson: None. S.K. Koliwad: Other Relationship; National Institutes of Health. Advisory Panel; Signos. Stock/Shareholder; Signos. R.J. Rushakoff: None.
