FDA Clears Intravenous Insulin Dose Calculator

Oooh, here’s one I hadn’t heard of before: EndoTool Glucose Management SysteEndotoolm, “a solution to the problem of how to effectively and safely control blood glucose for critically ill patients after surgery” — from a company called MD Scientific.

Glucose control for hospitalized patients is apparently notoriously bad, which (as you can imagine) leads to all sorts of problems:

“According to the Centers for Disease Control and Prevention in Atlanta, each year over 2 million patients acquire infections in U.S. hospitals, resulting in 90,000 deaths and costing an estimated $50 billion in medical charges. High blood glucose levels compromise the immune system and leave patients vulnerable to infections. Controlling blood glucose for patients in critical care has been shown to reduce infections and death.”

EndoTool software, approved by the FDA this week, is already being employed in 6,400 US hospitals. It keeps a record of all blood sugar values and insulin doses, which physicians can easily monitor, analyze, forward, and print. Presumably the intravenous “reader” is some kind of cannula or wireless pod, although I can only guess since the company’s web site doesn’t explain.

Very interesting, however. Good to know that if myself or some other PWD is going in for surgery — any surgery — doctors will have a powerful way to regulate our blood sugar.

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5 Responses

  1. JasonJayhawk
    JasonJayhawk June 22, 2006 at 3:17 pm | | Reply

    This company is not the first to come out with inpatient algorithms for insulin dosing. Several others are mentioned in papers in the Diabetes Theraputics and Technology journal. I think someone even came out with a freeware one that they “intend” to post on sourceforge.net at some point. They base it on an expert system and it helps a “diabetes layperson” (nurses) deal with the dosing; after all, many new nurses don’t even know what one unit of insulin looks like in a syringe.

    The interesting thing is that the software will cost a bundle for hospitals because they need to store up a legal fund for potential deaths caused by bad advice from the software. Hence, you’ll notice that they are a “limited liability company.” This is very important, as one wrongful death lawsuit would take them out of business.

    The reason you don’t see software making recommendations for outpatients (yet) is the legality of how to deal with bad advice. There is no way to predict when the person exercises or not, or when they eat something with higher fat or not.

  2. AmyT
    AmyT June 22, 2006 at 5:42 pm | | Reply

    Thanks for the background, Jason. I think this particular software is used mainly while patients are unconscious.

  3. medmusings
    medmusings June 22, 2006 at 11:18 pm | | Reply

    links for 2006-06-23

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  4. JasonJayhawk
    JasonJayhawk June 23, 2006 at 7:55 am | | Reply

    [Insert funny response to Amy's comment about unconsciousness here].

    Think they’ll make one for us to use during boring car rides?? Then our loved ones can inject for us while we’re snoozing? I can just see it now… my wife coming at me with shakey hands, attempting to give me insulin, and then her hand jerks enough to break the neeeee—-nevermind. I’m having a waking nightmare!

  5. Scott
    Scott June 26, 2006 at 5:38 am | | Reply

    One of my favorite comment related to diabetes management is actually a quote from a Chemistry textbook, but one which describes diabetes management pretty well”

    “Most chemists believe that the course of a chemical reaction is always predictable. But some catalytic reactions in both inorganic and organic chemistry can behave in bizarre and unruly ways.”

    From Stephen Scott, Clocks and Chaos in Chemistry
    December 2, 1989, New Scientist magazine, Issue 1693

    http://www.newscientist.com/article/mg12416933.700.html

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