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Diabetes can be a difficult disease to manage, requiring considerable education and constant monitoring. UVA Health is expanding a software system called Glucommander to make it easier for teams to care for patients in the hospital who are using an insulin drip to manage their diabetes or high blood sugar.

Glucommander is a prescription-only software medical device for glycemic management. The system uses a computer-based algorithm to personalize insulin doses based on the patients’ glucose values and adjusts over time based on patient needs.

The system has been used for years in the Heart and Vascular Center and will eventually be implemented across University Hospital. On Monday, Nov. 8, Glucommander launched in several areas, including select intensive and intermediate care units.

The system is designed to improve patient safety and quality of care by getting patients into target range faster with fewer insulin-related adverse drug events such as hypoglycemia (low blood sugar).

“It is more effective than our current UVA adult infusion protocol in reaching target range and staying in target range without stopping and restarting the infusion,” says Judy Smith, RN, Cardiovascular Intensive Care Unit. “It prevents severe hypoglycemic events by adjusting to the patient’s own insulin sensitivity over time. It saves time and stress for the nursing staff by not requiring math with each insulin does change.”

Benefits for the patients include more time in target range, avoidance of hypoglycemia, less glucose variability, and built-in warning reminders for potential for hypoglycemia with more frequent blood glucose (BG) checks if BG is falling too quickly.

Changes for Team Members in Their Day-to-Day Operations

Inpatient units that have the technology will have a patient status board near their nursing stations that serves as a reminder to check BG as needed. An alarm will sound when a BG check is due and indicate which patient needs attention.

If a patient is in range for several hours, the frequency of the checks will automatically reduce to every two hours. The system replaces the need for bedside nurses to remember to check a blood sugar and do manual calculations, which will increase patient safety and confidence.

Team member training has been underway since October, and as Glucommander launches around the hospital, ongoing support will be available.

“There will be superusers in your units as well as clinical experts in your area to assist you with this tool, “says Bob Anthony, Director, Inpatient Heart & Vascular. “Also, there will be a desktop icon that provides resources to address questions and provide further information on Glucommander management.”

Rollout and Timeline

Glucommander rolled out Nov. 8 in the Nerancy Neuroscience ICU, Neurology IMU, Surgical Trauma ICU, Surgical IMU, Medical ICU, Anesthesia, and Post-Anesthesia Care Unit.

Women’s Services is expected to receive the technology in January, and a rollout in Acute Care/Emergency Department is expected in March.

Questions? Contact the following experts with questions about Glucommander:

• Jennifer Kirby, MD, Associate Professor, Endocrinology | jkd2a@hscmail.mcc.virginia.edu
• Tracey Justus, Manager, Electronic Medical Record | tdj8d@hscmail.mcc.virginia.edu
• Bob Anthony, Director, Inpatient Heart & Vascular | rwa6k@hscmail.mcc.virginia.edu