Introduction and Objective: Given the global diabetes epidemic, the burden of inpatient glycemic care continues to increase. Poor inpatient glycemic control is associated with adverse patient outcomes, yet scalable hospital-wide solutions for real-time glucose management remain limited. We evaluated the long-term impact of an electronic medical record (EMR)-integrated, hospital-wide remote glycemic management system at a public medical center.Methods: A dynamic EMR-based dashboard integrating point-of-care and laboratory glucose data identified poor glycemic control as hyperglycemia (≥300 mg/dL on ≥2 occasions) or hypoglycemia (<70 mg/dL), including severe hypoglycemia (<50 mg/dL) within 24 hours. Automated warnings, real-time hypoglycemia alerts, and daily virtual recommendations were implemented. Outcomes were evaluated retrospectively across pre-implementation (2016), development (2017), and implementation (2018 onward) phases.Results: During the observation period, the mean number of hospitalized patients undergoing glucose monitoring increased from 332 to 646 per day. Following hospital-wide implementation (2016 vs. 2025), poor glycemic control decreased by 48% (10.2 to 5.3 per 100 monitored patient-days). Hyperglycemia (>300 mg/dL) declined by 50% (6.1 to 3.1), hypoglycemia (<70 mg/dL) by 54% (4.2 to 2.0), and severe hypoglycemia (<50 mg/dL) by 65% (0.96 to 0.33 per 100 monitored patient-days). Treat-to-target performance (70-180 mg/dL) improved from 49.2% to 63.2%.Conclusion: A hospital-wide, EMR-integrated remote glycemic management system was associated with sustained improvements in inpatient glycemic control, with concurrent reductions in hyperglycemia and hypoglycemia, without increased hypoglycemic risk. During the COVID-19 pandemic, the system maintained hospital-wide glycemic surveillance and remote specialist support despite workflow disruptions, supporting quality, safety, and resilience in inpatient diabetes care.
Y. Sheen: None. H. Chien Chung: None. M. Tseng: None. H.P. Chen: None. J. Chen: None. J. Wang: None.
Taichung Veterans General Hospital
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