Feasibility and safety of using an automated decision support system for insulin therapy in the treatment of steroid-induced hyperglycemia in patients with acute graft-versus-host disease: A randomized trial

J Diabetes Investig. 2019;10(2):339-342.


Steroid-induced hyperglycemia (SIHG) has shown to independently increase the risk for mortality in patients with acute graft-versus-host disease, and it is still unclear whether SIHG might be a modifiable risk factor. Therefore, a feasibility trial was carried out aiming to evaluate the performance of a standardized decision support system (GlucoTab [GT]) for insulin therapy in patients with SIHG. A total of 10 hyperglycemic acute graft-versus-host disease patients were included and treated either with GT or standard of care during hospitalization. Follow-up duration was 6 months. Comparing the GT versus standard of care group, 364 versus 1,020 glucose readings were available during a median of 41 days (interquartile range [IQR] 22-89) and 101 days (IQR 55-147) of hospitalization. The median overall glucose levels were 151 mg/dL (123-192) versus 162 mg/dL (IQR 138-193) for GT and standard of care, respectively (P < 0.001); hypoglycemia rates were comparably low. Treatment of SIHG with an algorithm-based system for subcutaneous insulin was feasible and safe.


Felix Aberer (1), Julia K Mader (1), Julia Holzgruber (1), Christian Trummer (1), Verena Schwetz (1), Marlene Pandis (1), Peter N Pferschy (1), Hildegard Greinix (2), Norbert J Tripolt (1), Thomas R Pieber (1, 3, 4), Armin Zebisch (2), Heinz Sill (2), Albert Wölfler (2, 3), Harald Sourij (1, 3)


  1. Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
  2. Division of Hematology, Medical University of Graz, Graz, Austria.
  3. Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
  4. Health-Institute for Biomedicine and Health Sciences, Graz, Austria.