Hospital Hyperglycemia: Status Investigation and Effect of a Real-time
Glycemic Alert System
Abstract
OBJECTIVE Hospital hyperglycemia is common and associated with potential
adverse outcomes. A Hospital-wide Mobile Phone Alert (HMA) system was
built to achieve real time glucose monitoring with warnings for glucose
excursions. This study investigated the status of glucose control and
evaluated the impact of HMA system on inpatient glycemia management.
METHODS Inpatients with hyperglycemia hospitalized between 1 January,
2017 and 31 December, 2018 were identified excluding those <
18 years of age. The HMA system was activated on 1 October, 2017. It
sent real time cellphone warning messages to the patient’s designated
team physician whenever glucose levels > 10 mmol/L or
< 3 mmol/L were detected. A serum glucose > 7.8
mmol/L was defined as hospital hyperglycemia (HH), and > 10
mmol/L was defined as significant HH (SHH). Glucose excursions before
and after the HMA system was instituted were compared. RESULTS The
incidence of HH, SHH and hypoglycemia was 26.1%, 12.8% and 2.5%,
respectively. With the HMA system, the monthly glucose related
consultation rate for all inpatients increased 65.9%. The rate of HH
glucose amount/ total glucose amount improved with the HMA system, being
lower than pre HMA system activation for the surgical wards (15.8 ±
4.7% vs 21.1 ± 6.1%,p<0.05). CONCLUSIONS In this study, one
third of inpatients were noted to experience hyperglycemia. Real time
cellphone warning messages to the patient’s designated team physician
can improve consultation utilization for blood glucose excursions. The
alert system was found to reduce the incidence of hyperglycemia on
surgical wards.