Dicker D, Marcoviciu D, Beylin V, Belnik Y and Solun B
Background: Hyperglycemia in hospitalized patients is found to be associated with increased risk of complications, systemic infections and mortality. Thus, managing and controlling glucose blood levels in these patients are essential. The aim of the present retrospective study was to evaluate the efficacy of standardized electronic insulin orders, using a computerized physician order entry (CPOE), in controlling blood glucose levels, preventing hypoglycemic events and reducing the variability of daily blood glucose levels during hospitalization of patients with diabetes mellitus in internal medicine departments.
Methods: Data were obtained from an internal medicine unit that used the standardized electronic insulin orders (Department 7) and compared to data from 6 other internal medicine departments in which the standardized electronic insulin orders was not used (Departments 1-6). The variability of daily changes in blood glucose levels was determined by the standard deviation of the daily changes and respective coefficient of variation.
Results: 130,078 point-of-care bedside glucose tests were recorded from 13,577 hyperglycemic patients. The average daily mean blood glucose levels were significantly lower in patients from Department 7 than from Departments 1-6. The rate of patients achieving average daily mean blood glucose levels ≤ 180 mg/dL was higher in Department 7 than Departments 1-6. The percent of patient days with hypoglycemia and the variability of daily changes in blood glucose levels were significantly lower in Department 7 than Departments 1-6.
Conclusions: A standardized electronic insulin orders of basal/bolus regimen improves glucose control in hospitalized patients.