2026 Eastern States Conference

Authors: Emma Twombly, PharmD, Christopher Devine, PharmD, BCPS, BCCCP, Jessica Marx, PharmD, BCPS 

Learning objective: Audience members will be able to explain the impact of pharmacist interventions on hyperglycemia outcomes in the hospital setting 

Background: The objective of this study is to compare the rates of hyperglycemia pre and post pharmacist insulin education. Pharmacist interventions on insulin will improve hyperglycemia rates in the hospital setting. 

Methods: This retrospective study analyzed patients admitted to a 240-bed teaching hospital. An integrative clinical pharmacy workflow tool that alerts pharmacists to potential interventions identified patients receiving insulin with at least two blood glucose readings ≥180 mg/dL. Patients ≥18 years old with at least two blood glucose readings ≥180 mg/dL were included. Patients were excluded if they were pregnant, on an insulin pump, length of stay <48 hours or who initially presented with DKA or HHS. Patient insulin regimens were reviewed for changes to assess the primary outcome of rates of hyperglycemia pre and post pharmacist education. Secondary outcomes analyzed hypoglycemic events, development of DKA, and length of stay.  

Results: 539 patients were reviewed pre pharmacist education with 14 excluded due to presenting with DKA or HHS. 491 patients were reviewed post education with 12 excluded due to presenting with DKA or HHS. 258 patients pre pharmacist education and 269 patients post pharmacist education met the inclusion criteria. The rate of hyperglycemia was 46% in the pre pharmacist education group and 55% in the post pharmacist education group (p=0.41). In the pre pharmacist education group, 17% of patients had a hypoglycemic event compared to 10% in the post pharmacist education group. No patients in either group developed DKA during their hospital stay. The average length of stay in both groups was approximately 10 days.

Conclusion: The results of this study showed clinical significance despite not being statistically significant. Despite some patients remaining hyperglycemic, when insulin regimens were adjusted in the post pharmacist education group, blood glucose readings improved. Some patients had blood glucose readings <180 mg/dL after their insulin regimen was adjusted by the pharmacist. There were fewer hypoglycemic events (blood glucose <70 mg/dL) in the post pharmacist education group suggesting insulin regimens were appropriately adjusted.
This research was supported by HCA Healthcare and reviewed by the IRB. The views expressed in this publication represent those of the authors and don’t necessarily represent the official views of HCA Healthcare or any of its affiliated entities.