Innovative Strategies for Glycemic Control at UHealth Tower
Summary
- UHealth Tower’s approach to inpatient diabetes care exemplifies the integration of evidence-based guidelines, policy-driven interventions and innovative technology.
- Poor glycemic control in hospitalized patients increases the risk of infection, morbidity and surgical complications.
- Future UHealth Tower research will focus on tracking readmission rates and post-discharge mortality, comparing continuous glucose monitoring with traditional monitoring and refining perioperative glycemic control for high-risk patients.
Achieving optimal glycemic control in hospitalized patients is essential for safe and effective care, directly impacting outcomes and hospital quality metrics. UHealth Tower recognizes this priority and, through a multidisciplinary team, has aligned its clinical practices with the latest recommendations from the American Diabetes Association (ADA) and other leading organizations.
“UHealth Tower’s approach to inpatient diabetes care exemplifies the integration of evidence-based guidelines, policy-driven interventions and innovative technology,” said Gianluca Iacobellis, M.D., Ph.D., professor in the Division of Endocrinology, Diabetes and Metabolism at the University of Miami Miller School of Medicine and director of the University of Miami Hospital Diabetes Service. “By collaborating among clinical teams and leveraging data-driven alerts, the hospital is setting new standards for glycemic control and patient safety.”
Improving Inpatient Diabetes Management
Poor glycemic control in hospitalized patients increases the risk of infection, morbidity and surgical complications. UHealth Tower is mitigating these risks through targeted initiatives that enhance diabetes management during admission.
Per UM policy, anti-diabetic oral agents with hypoglycemia risk are discontinued at admission. Coordinating insulin administration with meals helps prevent low blood sugar, and providers are alerted if patients refuse insulin. Educational resources support adherence and address patient concerns. The diabetes service also uses an Epic BPA alert to identify patients at high risk for hypoglycemia.
Working collaboratively, the UM Hospital Diabetes Service, UHealth Tower leadership and the diabetes taskforce continue to implement strategies to reduce 30-day readmissions and post-discharge mortality. Current projects include a post-discharge clinic for high-risk patients, diabetes kits for those discharged on insulin and pilot programs offering continuous glucose monitoring devices with patient education to improve outcomes.
“Technology and education are transforming diabetes care at UHealth Tower,” said Dr. Iacobellis, who added that his work with UHealth nurses on these care initiatives is one of many examples of collaboration that contributed to UHealth achieving Magnet with Distinction® from the American Nurses Credentialing Center’s Magnet Recognition Program®. “By combining innovation with a strong focus on patient support and follow-up, we’re ensuring smoother transitions of care and lasting improvements in outcomes.”
Evidence-Based Inpatient Care
These initiatives are grounded in evidence-based practice and continuous quality improvement. The team reviewed ADA standards, which recommend maintaining blood glucose levels between 140 and 180 mg/dL for critically ill patients and 100 to 180 mg/dL for patients who aren’t critically ill. These targets were adapted for the hospital setting, considering the influence of medications, acute illness, surgery and nutritional status.
“Quality measures were central to this effort, with the Centers for Medicare and Medicaid Services Hospital-Acquired Condition 09 (HAC-09) serving as a benchmark for poor glycemic control,” Dr. Iacobellis said. “Consensus from the ADA, Endocrine Society and American Association of Clinical Endocrinology supports UHealth Tower’s glycemic targets and structured order sets.”
These organizations advocate for standardized hypoglycemia management protocols and recognize the benefits of continuous glucose monitoring in inpatient care. Structured protocols and prompt provider alerts for blood glucose levels outside safe ranges have already improved hypoglycemia prevention and enhanced patient safety.
Looking Ahead
The UM Hospital Diabetes Service continues to monitor the impact of new initiatives such as continuous glucose monitoring deployment and expanded patient education. Future research will focus on tracking readmission rates and post-discharge mortality, comparing continuous glucose monitoring with traditional monitoring and refining perioperative glycemic control for high-risk patients. The team also plans to study how improved clinical documentation can reduce HAC-09 cases and strengthen care coordination.
Tags: blood sugar, diabetes, Diabetes Research Institute, Division of Endocrinology Diabetes and Metabolism, Dr. Gianluca Iacobellis, metabolism and diabetes, type 1 diabetes, type 2 diabetes, UHealth Tower