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<p class="MsoNormal"><b><span style="font-size:12.0pt">Inpatient & Emergency Department Providers<o:p></o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:12.0pt">**Excludes Peds & OB**<o:p></o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:14.0pt"><o:p> </o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:12.0pt">Glucommander Go Live Reminders:<o:p></o:p></span></b></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l0 level1 lfo1"><b>Glucommander Lantus Order<o:p></o:p></b></li><ul style="margin-top:0in" type="circle">
<li class="MsoNormal" style="mso-list:l0 level2 lfo1"><b><span style="color:red">Glucommander requires the Glucommander specific Lantus order to initiate a patient in Glucommander</span></b>. To ensure the appropriate orders are placed, follow the steps below:<b><o:p></o:p></b></li></ul>
</ul>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in">1. Discontinue all previous hypoglycemic treatments, Lispro and Lantus orders.<o:p></o:p></p>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in">2. Discontinue all non-insulin anti-diabetic medication.<o:p></o:p></p>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in">3. Place Initiate Glucommander SubQ Order Set<o:p></o:p></p>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in">4. Review Due time of the Lantus dosing (change to appropriate time based on previous Lantus dose).
<o:p></o:p></p>
<p class="MsoNormal" style="margin-left:1.0in;text-indent:.5in"> <b>
<span style="color:red">Important: </span></b>Ensure patients with Type 1 Diabetes do not go without basal insulin.<b><o:p></o:p></b></p>
<p class="MsoNormal" style="margin-left:1.0in"><o:p> </o:p></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l0 level1 lfo1"><b>Candidates for Glucommander SubQ<o:p></o:p></b></li><ul style="margin-top:0in" type="circle">
<li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patient requires insulin therapy (basal/bolus) but an IV insulin infusion isn’t indicated.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patient has Type 1 Diabetes.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patient has Type 2 Diabetes on insulin prior to admission.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patient has Type 2 Diabetes, not on insulin prior to admission, but has persistent hyperglycemia > 180 mg/dL.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patient with no history of diabetes with persistent hyperglycemia > 180 mg/dL (e.g., stress or steroid-induced).<o:p></o:p></li></ul>
</ul>
<p class="MsoNormal" style="margin-left:1.0in"><b><span style="color:red">Note:</span></b><span style="color:red">
</span><b>All other Insulin orders should be discontinued and no other insulin orders placed.</b>
<o:p></o:p></p>
<p class="MsoNormal" style="margin-left:1.0in"><b><o:p> </o:p></b></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l0 level1 lfo1"><b>Not a Candidate for Glucommander SubQ<o:p></o:p></b></li><ul style="margin-top:0in" type="circle">
<li class="MsoNormal" style="mso-list:l0 level2 lfo1">Patients who do not require Inpatient Basal insulin.
<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">On continuous TPN/TF + bolus TF.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Eating more than 3 meals + bedtime snack.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">On concentrated insulins during hospitalization.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">On premixed insulins during hospitalization.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">On insulin pumps during hospitalization.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Declining BG checks or insulin management.<o:p></o:p></li><li class="MsoNormal" style="mso-list:l0 level2 lfo1">Unstable, critically ill (use Glucommander IV).<o:p></o:p></li></ul>
</ul>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="color:red">Precautions:<o:p></o:p></span></b></p>
<ul style="margin-top:0in" type="disc">
<ul style="margin-top:0in" type="circle">
<li class="MsoNormal" style="mso-list:l0 level2 lfo1">Not commonly recommended to continue non-insulin diabetes agents in the hospital setting.<o:p></o:p></li><ul style="margin-top:0in" type="square">
<li class="MsoNormal" style="mso-list:l0 level3 lfo1">Continuing these agents may increase the patient’s risk of hypoglycemia.
<o:p></o:p></li></ul>
</ul>
</ul>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><b>To learn more about the Glucommander SubQ provider workflows,
<a href="https://www.upstate.edu/ihospital/intra/glucommander/glucommander-sq.php">
click here</a>. <o:p></o:p></b></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><img border="0" width="596" height="135" style="width:6.2083in;height:1.4062in" id="Picture_x0020_3" src="cid:image001.png@01D99868.63DB7DD0" alt="IMAGE"><o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
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