A study by the IISPV and the Joan XXIII University Hospital of Tarragona will allow the creation of apioneering device for more accurate follow-up of patients with diabetes admissions and to reduce the risk of derivatizations

• It is a software that will allow insulin doses to be adjusted more appropriately to the blood glucose levels of patients with diabetes who are admitted to both hospitals and other healthcare centers.

• It is known that in patients with diabetes admitted for any disease, the possibility of complications decreases if they have controlled glucose levels.

Diabetes is a complex and chronic metabolic disorder that is characterized by high blood glucose levels. It can be accompanied by other health problems such as hypertension, obesity, cardiovascular conditions or chronic kidney disease.

The treatment and management of diabetes are complex because each patient requires individual and regular adjustments in therapy under the attention of healthcare professionals. The amount of insulin to be administered to the patient is determined based on the blood glucose at that time and the conditions that are not available. Poor glucose control in patients with diabetes can lead to hospital admissions, prolonged hospital stays, increased risk of infection, deterioration following a myocardial infarction or falls, acute respiratory and renal failure, and even death.

When patients are admitted to hospital, it is often necessary to adapt their usual diabetes therapy and the use of subcutaneous insulin is recommended, since oral drugs (which are what they usually take) can interfere with other treatments or insulin requirements can change rapidly due to the illness that has caused the admission. Each patient requires individual adjustments, to avoid dangerous hyperglycemia or hypoglycemia episodes. At the moment, no solution has yet been found that allows the automation and standardization of diabetes treatment and management for each hospitalized patient. In this sense, being able to develop and implement an algorithm with the help of AI is key: it would help healthcare professionals make better decisions and benefit the health of these patients.

With the aim of providing solutions to this reality, the Study Group on Metabolic Diseases Associated with Insulin Resistance (GEMMAIR), formed by researchers from the Pere Virgili Health Research Institute (IISPV) and healthcare personnel from the Internal Medicine Unit of the Joan XXIII University Hospital in Tarragona, is working on a research project together with different European partners for the implementation and evaluation of a therapeutic decision software. This is an algorithm that will allow for more accurate monitoring of the blood glucose levels of these patients when they are admitted, while also allowing for an indication of the insulin dose to be given. “We have seen that when these patients are admitted to a hospital and have their glucose levels under control, they have a lower risk of complications and mortality,” explains Dr. Teresa Auguet Quintillà, head of the GEMMAIR Research Group and head of the Internal Medicine Service at the Joan XXIII Hospital in Tarragona.

The result of the efforts of the researchers at the IISPV, the healthcare team of this
internal medicine service and the rest of the European partners, the software (known as GlucoTab and designed to be used on digital devices) will be validated and in the future it will be possible to implement it in hospitals, nursing homes and home care. “When a person with this pathology is admitted to a hospital, their glucose levels are meticulously monitored to avoid the risks previously described. The insulin doses are adjusted depending on their progress and based on different parameters. Thanks to this device and with the help of artificial intelligence, this adjustment will be more accurate and can be made by the nurse herself (with final validation by the internal medicine healthcare staff). If this tool is validated, it will be possible to use it later not only in hospitals, but also in primary care centres or nursing homes, facilitating the work of professionals”, adds Dr. Auguet.

The Medical University of Graz (Austria) is the institution leading the project, which will be implemented in different healthcare centers in Europe thanks to the collaboration with EIT Health and its partners in Spain (the Pere Virgili Health Research Institute, the Jordi Gol i Gurina University Institute for Primary Health Care Research Foundation (IDIAPJGol) and the Catalan Health Institute), Sweden (Stockholm Danderyd University Hospital region), Denmark (Hovedstaden Steno Diabetes Center region) and the Czech Republic (Institute for Clinical and Experimental Medicine).