SHM Converge Scientific Abstract ePoster Gallery-Prevalence of Low-Value Inpatient Point of Care Glucose Monitoring

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This retrospective cohort study examined the prevalence and characteristics of low-value point-of-care glucose (POC-G) monitoring in non-critically ill hospitalized adults across five Johns Hopkins hospitals (2015–2019). Guidelines recommend insulin for persistent hyperglycemia and a target inpatient glucose range of 140–180 mg/dL, but they do not clearly address when glucose monitoring can be safely reduced. The study defined low-value POC-G testing as continued monitoring in patients who never developed hyperglycemia (no glucose value ≥180 mg/dL) and therefore did not meet criteria for correctional insulin.<br /><br />After applying inclusion and exclusion criteria, 23,134 patients were analyzed and divided into three groups: those who never exceeded 140 mg/dL, those whose glucose rose to 141–180 mg/dL, and those with at least one value >180 mg/dL. Patients with higher glucose values tended to be older, had higher BMI, more diabetes, and higher HbA1c levels.<br /><br />The study found substantial testing burden even among patients without hyperglycemia. On average, patients who never received insulin underwent 45,942 POC-G tests, and patients who did not meet the hyperglycemia threshold underwent an additional 105,686 tests. These findings suggest a large amount of potentially unnecessary glucose monitoring, contributing to nursing workload, resource use, and patient discomfort.<br /><br />The authors conclude that low-value POC-G monitoring is common in hospitalized non-critically ill patients and that further research is needed to identify which patients can safely have glucose monitoring de-escalated earlier.

Asset Subtitle

Niloofar Latifi

Meta Tag

Author List Daniel J. Brotman, Jianqiao Ma, Megan Tschudy, Mohammed Abusamaan, Nestoras ? Mathioudakis, Niloofar Latifi, Sarah Olson

Category Research

Concept Inpatient Diabetes Management

Concept Glucose Monitoring

Concept Insulin Therapy

Concept Inpatient Blood Glucose Target Range

Concept Hyperglycemia

Distinguished Non-Finalist

Presenter Organization Johns Hopkins School of Medicine

Presenting Author Niloofar Latifi

Track Value in Hospital Medicine

Keywords

point-of-care glucose

low-value monitoring

hospitalized adults

retrospective cohort

hyperglycemia

insulin guidelines

inpatient glucose

nursing workload

glucose testing burden

Johns Hopkins hospitals

Inpatient Diabetes Management

Glucose Monitoring

Insulin Therapy

Inpatient Blood Glucose Target Range

Hyperglycemia