Use of an Electronic Health Record–Embedded Glycemic Management Protocol to Improve Perioperative Glucose Control in People With Diabetes
Authors' conclusion
Implementation of a digitally embedded perioperative glycemic management protocol improved glucose monitoring and intraoperative glucose control without increasing hypoglycemia. These findings support the safe and effective use of the protocol across surgical specialties and case urgencies, supporting the value of integrating decision support tools into clinical workflows.
Study context
- Population
- Adults with diabetes undergoing noncardiac surgery with >2 hours of procedure time
- Participants
- 1,254 adults
- Exposure
- Post-implementation of EHR-embedded perioperative glycemic management protocol vs pre-implementation
- Post-interventionn = 620
- Pre-interventionn = 634reference
- Outcome
- Proportion of intraoperative glucose readings within 70 to 180 mg/dL
- Follow-up
- Intraoperative
Methodological detailsbefore-after, single-centre, tertiary-care academic hospital, pre- vs post-implementation
- Before-after
- Single-centre
- Tertiary-care academic hospital
- Pre- vs post-implementation
Main finding
As reported in the abstract
Pre-intervention
0.65
mean
Post-intervention
0.72
mean
P = 0.021
Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| Glucose monitoring and IV insulin use · all phases of careIncrease after implementation | P < 0.001 |
Safety
Hypoglycemia, preoperative phase · reduced risk after implementation
P = 0.007
Hypoglycemia, intraoperative and post-anesthesia care unit (PACU) phases
- No increased risk of hypoglycemia in the intraoperative or PACU phases
Original publication
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