Hospital Diabetes Meeting 2020

Abstract

Patients with diabetes may experience adverse outcomes related to their glycemic control when hospitalized. Continuous glucose monitoring systems, insulin-dosing software, enhancements to the electronic health record, and other medical technologies are now available to improve hospital care. Because of these developments, new approaches are needed to incorporate evolving treatments into routine care. With the goal of educating healthcare professionals on the most recent practices and research for managing diabetes in the hospital, Diabetes Technology Society hosted the Virtual Hospital Diabetes Meeting on April 24-25, 2020. Because of the coronavirus disease 2019 (COVID-19) pandemic, the meeting was restructured to be held virtually during the national lockdown to ensure the safety of the participants and allow them to remain at their posts treating COVID-19 patients. The meeting focused on (1) inpatient management and perioperative care, (2) diabetic ketoacidosis and hyperglycemic hyperosmolar state, (3) computer-guided insulin dosing, (4) Coronavirus Disease 2019 and diabetes, (5) technology, (6) hypoglycemia, (7) data and cybersecurity, (8) special situations, (9) glucometrics and insulinometrics, and (10) quality and safety. This meeting report contains summaries of each of the ten sessions. A virtual poster session will be presented within two months of the meeting.

Inpatient Insulin Pen Implementation, Waste, and Potential Cost Savings: A Community Hospital Experience

“…Inpatient diabetes management teams may not be available at other institutions; caution should be taken in extrapolating these results. 25 In a large academic medical center, a quality improvement project concluded that with proper medication safety features in place there are major benefits of using insulin pens in the inpatient setting. 26 In a pilot study conducted at the University of California, San Francisco Medical Center, it was determined that using the EHR to directly integrate patient safety improvements regarding insulin pens offered an opportunity to enhance patient safety.…”

Managing Patients Undergoing Orthopedic Surgery to Improve Glycemic Outcomes

“…Immediate priorities include appropriate fluid administration, electrolyte balance, and blood glucose management. Insulin is the pharmacologic agent of choice to manage blood glucose in hospitalized patients requiring glycemic management due to its quick onset and ease of adjustment based on dynamic individual needs [ 53 ]. Structured insulin order sets should be implemented to increase efficiency and decrease dosing errors.…”

“…Hospital diabetes management teams vary by institutions based on needs and resources. The increase in the diabetes population seeking care, advancement in diabetes therapies and technology, potential for improved outcomes, and cost savings are a few of the factors that support implementation of a diabetes management program [ 53 ]. Involvement of a diabetes service in select patients from the preoperative or admission phase to discharge enhances the entire perioperative experience and associated outcomes such as length of stay, readmission, and mortality [ 56 ].…”

The Endocrine Hospitalist: Enhancing the Quality of Diabetes Care

“…Or perhaps, endocrinologists may not have enough business/financial skills to put together a business plan? 34,45 Could there be a financial explanation? Endocrine hospitalists may not be able to generate enough revenue through billings to cover the entire cost of salaries and benefits, even if the impact on quality metrics is significant.…”