Standardized Glycemic Management with a Computerized Workflow and Decision Support System for Hospitalized Patients with Type 2 Diabetes on Different Wards

The following is a review of Neubauer et al. study on the management of glycemic standards using computerized workflow and decision support systems.

Introduction

CDS technology is an emerging field in health informatics which combines the critical thinking of men, and optimizes it with the aid of a computerized system to yield better funded and conclusions based on evidence based medicine.The implementation tools provided by this system have promising features for physicians and their teams to arrive to optimal conclusions in the patient health delivery system. Diabetes is a well known public health issue and its management represent a greater challenge in present years. Using a paper-based algorithm for basal bolus insulin therapy developed to improve the quality of glycemic control and hospital complications, Neubauer and her team adapted it into a moblie decision support system named GlucoTab® system.

Methods

This study was an open, noncontrolled interventional study in hospitalized patients with Type 2 diabetes. The study was conducted on four general wards of a tertiary-care hospital: Endocrinology, Cardiology, Nephrology and Plastic Surgery. 99 hospitalized patients were competitively recruited from May 2013 to December 2013

GlocoTab applied a daily dose of basal insulin, bolus insulin before each meal, and a correctional dose at bedtime to achieve fasting and premeal BG (Blood Glucose) values of less than 140 mg/dL. One-half of the total daily dose was administered as basal insulin once a day before lunch. The other half was administered as bolus insulin three times a day (45% of the total dose for breakfast bolus, 25% for lunch bolus, and 30% for dinner bolus).

• Daily dose: 0.5 units/kg