Research Article Addressing Inpatient Glycaemic Control with an Inpatient Glucometry Alert System J. N. Seheult, 1 A. Pazderska, 2 P. Gaffney, 1 J. Fogarty, 1 M. Sherlock, 2 J. Gibney, 2 and G. Boran 1 1 Clinical Chemistry Department, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland 2 Department of Medicine, Endocrinology Division, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland Correspondence should be addressed to J. N. Seheult; seheultj@tcd.ie Received 6 November 2014; Revised 27 May 2015; Accepted 8 June 2015 Academic Editor: Andre P. Kengne Copyright © 2015 J. N. Seheult et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Poor inpatient glycaemic control has a prevalence exceeding 30% and results in increased length of stay and higher rates of hospital complications and inpatient mortality. Te aim of this study was to improve inpatient glycaemic control by developing an alert system to process point-of-care blood glucose (POC-BG) results. Methods. Microsof Excel Macros were developed for the processing of daily glucometry data downloaded from the Cobas IT database. Alerts were generated according to ward location for any value less than 4 mmol/L (hypoglycaemia) or greater than 15 mmol/L (moderate-severe hyperglycaemia). Te Diabetes Team provided a weekday consult service for patients fagged on the daily reports. Tis system was implemented for a 60-day period. Results. Tere was a statistically signifcant 20% reduction in the percentage of hyperglycaemic patient-day weighted values >15mmol/L compared to the preimplementation period without a signifcant change in the percentage of hypoglycaemic values. Te time-to-next-reading afer a dysglycaemic POC-BG result was reduced by 14% and the time-to-normalization of a dysglycaemic result was reduced from 10.2 hours to 8.4 hours. Conclusion. Te alert system reduced the percentage of hyperglycaemic patient-day weighted glucose values and the time-to-normalization of blood glucose. 1. Introduction Hyperglycaemia and hypoglycaemia are prevalent in the inpatient setting. A recent analysis of hospital glucometry data by Bersoux and Cook from January to December 2012 was conducted on 51.4 million measurements from 2.6 million inpatients. Te authors found that the prevalence of hypoglycaemia (<4 mmol/L or 70 mg/dL) was 6.1% in non- ICU patients and 5.6% in ICU patients, while the prevalence of hyperglycaemia (>10 mmol/L or 180 mg/dL) was substan- tially higher at 32% in non-ICU patients and 28% in ICU patients. Te mean point-of-care blood glucose (POC-BG) was 167 mg/dL for non-ICU patients and 170 mg/dL for ICU patients. Te authors concluded that increased hospital par- ticipation in data collection was needed for the development of optimal practices to manage inpatient dysglycaemia [1]. Numerous studies have shown that improvement in gly- cemic control results in lower rates of hospital complications in general medicine and surgery patients [2–6]. In one study, newly discovered hyperglycaemia was associated with a higher in-hospital mortality rate (16%) compared with those patients with a prior history of diabetes (3%) and subjects with normoglycaemia (1.7%; both  < 0.01)[2]. At the opposite end of the glycaemic scale, studies have shown that in-hospital secondary hypoglycaemia increases inpatient mortality, likelihood of readmission, and length of stay [7–9]. Certain clinical situations increase the risk of dysgly- caemia during a hospital admission. Tese include changes in caloric or carbohydrate intake especially “nil by mouth” status or total parenteral nutrition [10]; use of diabetogenic medications like corticosteroids [11]; failure of medical staf to make adjustments to glycemic therapy based on daily blood glucose (BG) patterns [12]; prolonged use of sliding scale insulin regimens [13]; lack of coordination between insulin therapy, blood glucose monitoring, and meals [14]; issues Hindawi Publishing Corporation International Journal of Endocrinology Volume 2015, Article ID 807310, 8 pages http://dx.doi.org/10.1155/2015/807310