1083-P: Comparison of Hyperglycemia Management Protocols in the ICU: Standard Protocol vs. Electronic Glycemic Management System

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A variety of continuous insulin infusion (CII) algorithms are available to improve and maintain glycemic control in the ICU. In December of 2016, our institution, a community based academic hospital of 900 beds, acquired an electronic glycemic management system (eGMS, GlucommanderTM) for the management of ICU patients with hyperglycemia. We present our experience and compared glycemic control between patients managed with eGMS and standard care between December 2016 and December 2018. The standard care group included patients who were not on eGMS with at least 2 blood glucose readings >180 mg/dl during their ICU stay. The primary endpoint was a proportion of blood glucose (BG) readings between 70-180 mg/dl. Secondary outcomes included rates of hyperglycemia > 250 mg/dl, as well as rates of hypoglycemia < 70 mg/dl, < 54 mg/dl and <40 mg/dl, and patient-day rates for hypoglycemia. Among a total of 2897 ICU patients, 1971(68%) were treated with standard care and 926(32%) with eGMS. eGMS resulted in improved glycemic control with lower rates of hypoglycemia, Table. Conclusion: Treatment with eGMS significantly lowered the incidence of hypoglycemia and severe hyperglycemia compared to standard care in the ICU. eGMS is a safe and effective way to manage hyperglycemia in the ICU of an academic medical center. Disclosure G.E. Umpierrez: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc. Research Support; Self; AstraZeneca, Merck & Co., Inc., Novo Nordisk Inc., Sanofi US. J. Messler: Employee; Self; Glytec, LLC.