952-P: Improving Glycemic Management of Patients with Type 2 Diabetes in Acute Geriatric Care by Using a Basal Insulin Algorithm Incorporated into a Workflow and Decision Support System

Introduction: Glycemic management can be complex in elderly patients despite of multimorbidity and polypharmacy. International guidelines recommend individualizing therapy goals by using easy to handle basal insulin regimen with low hypoglycemia risk. An algorithm for basal insulin therapy (including basal-plus) based on the individual’s health status was developed and incorporated into GlucoTab®. This tablet-based workflow and decision support system provides suggestions for insulin therapy, blood glucose (BG) management and offers workflow support by visualization of open tasks. The study objective was to investigate efficacy and safety of the GlucoTab® system in patients at an acute geriatric hospital. Methods: A randomized controlled trial was performed in 58 patients with type 2 diabetes aged ≥ 65 years. Patients in the intervention group (IG) (n=31) were treated according to GlucoTab® basal insulin algorithm, patients in the control group (CG) (n=27) received diabetes therapy according to physician’s prescription electronically documented in GlucoTab®. Results: Patients of both groups (sex: IG=65% vs. CG=63% females, age: 78±6 vs. 76±6 years, BMI: 29±6 vs. 30±6 kg/m2 and HbA1c: 56±10 vs. 61±13 mmol/mol) were attributed an individual health status: 74% moderate and 26% good health. The percentage of fasting BG (FBG) values within health-dependent FBG target range was 59±33% vs. 51±31%. BG values below, within, and above health dependent target range occurred in 4%, 75% and 22% vs. 1%, 75% and 25%, respectively. In both groups no severe hypoglycemic event