Novel Inpatient Automated Self-Adjusting Subcutaneous Insulin Algorithm: 3-Year Experience. An Observational Study
Authors' conclusion
Patients had a lower proportion of both hypoglycemic and severely hyperglycemic measurements when their blood glucose levels were managed using the SQIA than when managed using conventional physician-driven insulin orders.
Study context
- Population
- Adult inpatients with hyperglycemia who were nil per os (NPO), on enteral tube feedings or on total parental nutrition (TPN), September 3, 2020 to September 2, 2023
- Participants
- 5,031 intervals
- Exposure
- Automated self-adjusting SC rapid-acting insulin algorithm (SQIA) vs conventional insulin treatment (CI)
- Outcome
- Proportion of q4 hour point-of-care (POC) glucose levels in ranges: hypoglycemia (<70 mg/dL), in range (71-180 mg/dL), moderate hyperglycemia (181-250 mg/dL), severe hyperglycemia (>250 mg/dL)
Main finding
As reported in the abstract
Proportion of POC glucose values in ranges
SQIA vs CIDifference (CI)P value
Hypoglycemia (<70 mg/dL): 0.65% vs 1.10%
−0.45%(−0.62 to −0.28%)
P < 0.001Severe hyperglycemia (>250 mg/dL): 5.40% vs 6.65%
−1.25%(−2.03% to −0.46%)
P = 0.002Observational data: associations, not effects.
Further findings
- Severe hyperglycemia rates lower with SQIA, particularly with high-dose glucocorticoids
- 11.1% lower
Safety
| Outcome | SQIA | CI | Difference (CI) | P value | |
|---|---|---|---|---|---|
| Hypoglycemia (<70 mg/dL), proportion of glucose values | 0.65% | 1.10% | −0.45% (−0.62 to −0.28%) | P < 0.001 | |
| −1−0.500.5Difference (linear scale) |
Original publication
Novel Inpatient Automated Self-Adjusting Subcutaneous Insulin Algorithm: 3-Year Experience. An Observational Study. J Clin Endocrinol Metab. Published 24 June 2025. doi:10.
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