INTRODUCTION
The prevalence of hyperglycemia in hospitalized patients is common and in our study varied from 12% to 50% of all inpatients at our facility1,2 1-3. Episodes of hyperglycemia were associated with several reasons, to include: history of diabetes mellitus (DM), newly diagnosed diabetes mellitus and stress-related hyperglycemia 4,5. Inpatient hyperglycemia has been associated with various adverse outcomes to include a higher mortality, longer hospital stay, increased infections, and complications 5,6. In clinic practice, the achievement of blood glucose goal in inpatients with hyperglycemia is not satisfied and a number of barriers can prevent the achievement7,8. The physician’s omissions of hyperglycemia and impaired medication timing due to hospital system are important reasons that impact the management of hospitalized patients7,8. While there have been numerous publications on how to improve the management of glucose excursions in hospitalized patients, available systems to date appear to have fallen short of achieving optimal results 9-13. Although diabetes management guidelines for inpatient diabetes advise the development and use of inpatient blood glucose monitoring systems, no gold standard models or systems presently exist.
We established a hospital-wide inpatient glucose management model for glucose monitoring and response to clinically relevant glucose excursions including: a glycemic care team (GCT), standard operation procedures (SOP), and glucose care information system (GCI). The GCI was integrated with our electronic medical record (EMR), and was developed to provide an alarm message whenever noting hyperglycemia (>7.8 mmol/L) or hypoglycemia (< 3 mmol/L) in a patient. This system was named the Hospital-wide Mobile Phone Alert (HMA) with it being developed to achieve real time warnings and resultant timely response for glucose excursions with the intent of improving overall glucose control. The study aimed to evaluate the impact of the system HMA on inpatient hyperglycemia control.