ArticleJournal of diabetes science and technology2018
Comparison of Computer-Guided Versus Standard Insulin Infusion Regimens in Patients With Diabetic Ketoacidosis.
Article in Journal of diabetes science and technology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Electronic Glycemic Management Systems Versus Conventional Insulin Infusion Protocols in Diabetic Ketoacidosis: A Systematic Review and Meta-Analysis of Non-Randomized Studies.Medicina (Kaunas, Lithuania) · 2026Pooled it
- American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022Guideline
- Remote Continuous Glucose Monitoring With a Computerized Insulin Infusion Protocol for Critically Ill Patients in a COVID-19 Medical ICU: Proof of Concept.Diabetes care · 2021Trial
- Algorithm-guided insulin therapy in hospitalized patients: current evidence, implementation challenges, and future perspectives.Reviews in endocrine & metabolic disorders · 2026Review
- Evaluation of electronic order set implementation in patients with diabetic ketoacidosis: a retrospective cohort study.Therapeutic advances in endocrinology and metabolism · 2026Article
- Advances in the management of hyperglycaemia and diabetes mellitus during hospitalization.Nature reviews. Endocrinology · 2025Review
- A clinical model for highly accurate prediction of blood glucose depression after continuous intravenous insulin therapy in hyperglycemic emergencies, a multicenter retrospective cohort study.Journal of diabetes investigation · 2025Article
- Association of Hypoglycemia With the Time to Dextrose in Treatment of Diabetes-Related Ketoacidosis.Clinical diabetes : a publication of the American Diabetes Association · 2025Article
- Toward Automation: The Road Traveled and Road Ahead for Integrating Automated Insulin Delivery into Inpatient Care.Diabetes technology & therapeutics · 2025Review
- Technology in the management of diabetes in hospitalised adults.Diabetologia · 2024Review
- Hypoglycemia during hyperosmolar hyperglycemic crises is associated with long-term mortality.Diabetology & metabolic syndrome · 2024Article
- Safety and Effectiveness of the Use of an Electronic Glucose Monitoring System Versus Weight-Based Dosing Nomogram for Treatment of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome in a VA Hospital.Journal of diabetes science and technology · 2023Article
- Evaluation of Computer-Based Insulin Infusion Algorithm Compared With a Paper-Based Protocol in the Treatment of Diabetic Ketoacidosis.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2023Article
- Clinical Decision Support for Glycemic Management Reduces Hospital Length of Stay.Diabetes care · 2022Article
- Electronic Health Record-Based Decision-Making Support in Inpatient Diabetes Management.Current diabetes reports · 2022Review
- Smart Insulin Pens: Advancing Digital Transformation and a Connected Diabetes Care Ecosystem.Journal of diabetes science and technology · 2022Article
- A quality improvement initiative to successfully reduce the frequency of hypoglycemia during treatment of hyperglycemic crises at an academic safety-net hospital: Insights and results.Journal of clinical & translational endocrinology · 2021Article
- Impact of Initial eGlycemic Management System Dosing Strategy on Time to Target Blood Glucose Range.Journal of diabetes science and technology · 2021Article
- Evaluation of the Efficacy and Safety of an eGlycemic Management System in a Community Hospital Setting.Journal of diabetes science and technology · 2021Article
- Insulin Infusion Computer Calculator Programmed Directly Into Electronic Health Record Medication Administration Record.Journal of diabetes science and technology · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study was performed to investigate the efficacy of Glucommander (GM) (Glytec®), a computer-based algorithm versus standard (paper form-based) continuous insulin infusion (CII) in the treatment of patients with diabetic ketoacidosis (DKA).
methodsThis was a retrospective multicenter study involving 2665 patients with DKA treated with either GM (n = 1750) or standard protocols (n = 915) across 34 institutions in the United States. GM estimates the rate of CII using an insulin sensitivity factor referred to as a "multiplier" that ranges between 0.01 and 0.03. Outcomes of interest were differences in time to resolve DKA (blood glucose [BG] <200 mg/dL and bicarbonate < 18 mmol/L) and number of hypoglycemic events defined as a BG <70 mg/dl.
resultsTreatment with GM was associated with lower rates of hypoglycemia during the time of the insulin drip (12.9% vs 35%, P = .001), faster time to normalization of blood glucose (9.7 ± 8.9 vs 10.97 ± 10.2 hours, P = .0001) and resolution of metabolic acidosis (13.6 ± 11.8 vs 17.3 ± 19.6 hours, P = .0001), and shorter hospital length of stay (3.2 ± 2.9 vs 4.5 ± 4.8 days, P = .01) compared to standard care. Best treatment outcomes were achieved with an initial multiplier of 0.01 and a glucose target range between 120 and 180 mg/dl.
conclusionThe GM algorithm in DKA treatment resulted in lower rates of hypoglycemia and faster DKA resolution over standard paper-based algorithms. Prospective randomized clinical trials comparing the efficacy and cost of computer-based algorithms versus standard CII regimens are warranted.
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