Three-year analysis shows a 98% reduction in severe hypoglycemia, low severe hyperglycemia, and comparable safety in severe renal impairment.
PALO ALTO, Calif. & LAS VEGAS–(BUSINESS WIRE)–Glooko, Inc., a globally integrated digital healthcare company focused on helping healthcare systems solve the growing challenges of glycemic safety and diabetes management across care settings, today announced data presented at the American Association of Clinical Endocrinology (AACE) Annual Meeting. The evidence, reflecting outcomes from a three-year retrospective analysis spanning from January 2023 through December 2025, demonstrated that EndoTool IV achieved a 98% reduction in severe hypoglycemia across a large, 19-hospital health system as compared with historical paper protocols. The poster titled, ‘Virtual Elimination of Severe Hypoglycemia Utilizing a Computerized Insulin Dosing Algorithm for Intravenous Insulin Infusions,’ was authored and presented by Joseph Aloi, M.D., F.A.C.E., Section Chief, Endocrinology and Metabolism at Advocate Health Wake Forest Baptist Hospital and Paul Chidester, M.D., Medical Director, EndoTool, at Glooko.
The analysis included 17,838 patients and 362,901 blood glucose values. Severe hypoglycemia (blood glucose less than 40 mg/dl) incidence dropped to 0.005% (18 readings) compared with 0.23% under paper protocols. Among 4,804 patients managed with diabetic ketoacidosis (DKA)-specific protocols, severe hypoglycemia incidence was 0.007%. In patients with severe renal impairment (eGFR <15), severe hypoglycemia incidence was 0.007%, compared with 0.005% in patients with eGFR >60. The analysis also found that EndoTool IV recommended prophylactic carbohydrates that helped avoid 2,213 potential episodes of hypoglycemia, while severe hyperglycemia (blood glucose greater than 300 mg/dl) remained low at 0.17%.
“Severe hypoglycemia is one of the most consequential risks in inpatient insulin management, especially in patients with impaired kidney function,” said Dr. Aloi. “What makes this data compelling is that we saw consistently low rates of severe hypoglycemia across a large real-world hospital population, including patients with severe renal impairment, while maintaining control of severe hyperglycemia.”
The findings reinforce EndoTool’s value proposition around patient-specific insulin dosing, powered by a multivariable model that incorporates key clinical factors such as renal function, steroid use, and estimated residual extracellular insulin (EREI). This approach is complemented by proactive carbohydrate recommendations when hypoglycemia appears imminent and therapy modes designed for complex inpatient scenarios such as DKA, HHS, and euglycemic DKA.
“These data reinforce an important point for healthcare systems: safer inpatient glycemic management requires more than static protocols,” said Dr. Chidester. “Hospitals need decision support that reflects how individual patients respond to insulin. EndoTool’s patient-specific dosing helps standardize care, reduce risk, and support frontline teams as glycemic safety becomes a more visible measure of performance.”
As hospitals face increasing scrutiny around performance on severe hypoglycemia and hyperglycemia, these data provide timely evidence that more precise inpatient insulin dosing can improve safety at scale while reducing burden at the bedside, including 55% fewer glucose checks and a 75% increase in nursing satisfaction.1,2
About Glooko
Glooko is a global digital health company focused on helping clinicians address the growing challenges of glycemic safety and diabetes management across the care continuum. Glooko is uniquely positioned to be the enterprise partner of choice for healthcare providers seeking to reduce glycemic risk, improve safety, and support overburdened clinical teams with coordinated expertise across both outpatient and inpatient care settings.
EndoTool is developed and marketed by Monarch Medical Technologies, LLC, a Glooko Company, and is a separate solution from the Glooko diabetes management platform. EndoTool is an FDA-cleared Class II medical device indicated for inpatient use as described in its Instructions for Use. Recommendations are intended to assist, and not replace, clinical judgment.
- Salim, K., Gomes, J., Calderon Martinez, E., Abedeen, D., Scheid, Z., Riaz, R., Ortiz, L., Schrader, A., Helmuth, A., Srivastav, S., Chidester, P., & Atrash, A. (2023). Evaluating the effect of EndoTool utilization for glycemic control in critically ill patients at UPMC Central Pennsylvania [Poster presentation]. 23rd Annual Diabetes Technology Meeting. https://monarchmedtech.com/wp-content/uploads/2023/11/UPMC-DST-Poster.pdf
- Dumont, C., & Bourguignon, C. (2012). Effect of a computerized insulin dose calculator on the process of glycemic control. American Journal of Critical Care, 21(2), 106–115. https://doi.org/10.4037/ajcc2012956
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