International guidelines recommend basal-insulin for elderly persons with type 2 diabetes for safe glycaemic control. An algorithm-based (basal, basal+ insulin) digital workflow and decision support system (GlucoTab@MobileCare) was developed and tested in a proof-of-principle study. The system enables independent insulin adjustments based on algorithm suggestions for daily visiting of domiciliary nursing staff. The aim of this retrospective analysis was to investigate diabetes-related acute hospital admissions six months before, during and after the study.
Nine patients (5 females, age 77±10 years, HbA1c: start 60±13, end 57±12 mmol/mol) were treated for three months with GlucoTab@MobileCare. Data from electronical health records were analyzed regarding acute hospital admissions due to diabetes-related reasons six months prior to study, during the study period and six months after study termination.
By using GlucoTab@MobileCare no acute diabetes-related hospital admissions occurred. Under routine care, in total six patients were admitted to the hospital. During six months prior to GlucoTab@MobileCare treatment, five emergency room (ER) visits occurred in three patients, resulting in four inpatient stays (length of stay (LoS): 11.3±3.4 days). During six months after GlucoTab@MobileCare treatment three ER visits occurred in two patients, resulting in two inpatient stays (LoS: 7.5±0.7 days). One patient was acutely admitted to the diabetes outpatient clinic. In eight cases, the cause for admission was hyperglycaemia; in one hypoglycaemia.
GlucoTab@MobileCare was able to prevent acute hospital admissions and subsequent inpatient stays due to blood glucose derailments. Further studies in a larger study population are needed to confirm these findings.