GlucoTab Version History

GlucoTab® Version 8.0 (February 2022)

New feature: Documentation intravenous insulin infusion with infusion pump

• New therapy type for documentation of intravenous insulin infusion with infusion pump
  • Preparation of the infusion
  • Specification of a blood glucose measurement frequency every x minutes
  • Scheme for proposed flow rate as a function of blood glucose that can be predefined
  • Continuous documentation of the flow rate with presentation in the course of therapy chart
• Changes in relation to i.v. insulin therapy
  • Better differentiation between the display of i.v. and s.c. insulin. insulin prescriptions in the therapy plan
  • The filter function in the drug selection dialogue is now dependent on s.c. or i.v. administration (insulin pen not for i.v., vial not for s.c.).

New: Availability of insulin degludec (Tresiba®, Novo Nordisk®) in GlucoTab Algorithm supported therapy

User Interface Improvements

• Fundamental reorganisation of the user interface so that the therapy course (chart with blood glucose and documented activities) and therapy plan (order) are aligned exactly on top of each other with the same time axis + technical realisation with new charting library.
• Possibility of configuring that drug doses or measured values are indicated to two decimal places.
• The ward abbreviations of the hospital information system are not understandable for users. A configurable mapping 1:1 or 1:n, also with wildcards, to human readable ward names was introduced.
• The fields displayed in the main patient view for patient identification are now configurable: Date of birth, PID, national insurance number

Improvements short acting insulin and supplement schemes

• When prescribing short-acting insulin, it is now possible to specify whether it should only be administered if the patient eats a meal.
• Extension of the functionality for supplement schemes by
  • the reduction of meal insulin for low blood glucose levels
  • Alternative correction scheme for the period bedtime/night (reduction of the correction dose of the day by x%)
• If the blood glucose value for the dose calculation according to the correction scheme is above the upper limit of the correction scheme, then a configurable message is displayed when the medication is administered, e.g. “Information to pysician on duty after administration of correction insulin”.

Extended functionality gestational diabetes

• Gestational diabetes is now available for documentation as additional diabetes type in the list (Until now “other diabetes type” was used also for patients with gestational diabetes). When gestational diabetes is selected, the “patient is pregnant” checkbox is automatically activated.
• For patients with gestational diabetes, configurable target ranges for postprandial measurements can be defined, e.g. after 1h pp: 140 – 180 mg/dl, after 2h pp: 120 – 160 mg/dl

Extended functionality for hypo- or hyperglycaemia

• Generation of a task for a control measurement also for high blood glucose values (configurable threshold) for all patients.
  Correct consideration when prescribing a correction scheme by which a control measurement is also generated for high blood glucose values.
• When a hypo- or hyperglycaemic BG value is measured, a task with configurable validity (e.g. 1h) is created and displayed in the task list and on the patient’s main screen. Clicking on the icon opens a dialogue that explains the general procedure and optionally provides a link to an internal guideline (PDF or HTML).

Extended features at therapy start

• It is now possible to configure that GlucoTab basal-bolus therapy can be started by nurses, when the name of the delegating physician is documented.
• Improved use of existing information on therapy to calculate the dose suggestion for the initial insulin daily dose in basal bolus therapy: The number of insulin units from prior therapy at home and/or current inpatient therapy is now also automatically determined.
• Allow the user to take over the last known inpatient therapy from a previous enrolment.

Documentation discharge therapy

• The previous therapy as well as the currently prescribed therapy can be output as a copyable character string in the text fields for the discharge therapy in order to take them over with copy & paste, e.g. in a discharge letter.

Improved wording and consistency

• Consistent function and display of the “Confirm”, “Save” or “Close” buttons
• Display of an explanation for dose entry with the keyboard in the drug prescription dialogue
• Mandatory setting of the start date when taking over a drug from the previous therapy with an administration frequency > 1 day
• Warning messages now better explain that total daily dose adjustment needs to be performed that the algorithm can calculate a dose suggestion (when the basal-bolus algorithm is in pending mode and medication administration is started).
• The error message “please contact technical support” can now be replaced by a customer-specific (configurable) string to allow more actionable information for users in case of a problem, e.g.: “Please write a support ticket to …”
• Improved wording in notification in Basal Only when new basal dose cannot be calculated due to missing bg measurements

Improvements integration: drug catalogue, organizational structure

• Incremental updates of the medication list now allow for frequent (daily) updates. In doing so, avoid as much as possible the situation where medication orders may no longer be edited after the update BUT recognize critical changes.
• Possibility of user assignment to one or more wards via ActiveDirectory roles and corresponding adjustment of the GlucoTab Launcher, close the Launcher window when logging out.
• When opening the patient list without a ward being selected: Allow selection of a ward instead of loading of all wards.

Bugfix

• Task generation for medication administration of a backdated task is now handled correctly

GlucoTab® version 7.0 (August 2020)

• Additional therapy algorithm for basal insulin therapy (BOT/BIT)
  • GlucoTab thus provides algorithm support for two types of therapy: GlucoTab basal bolus therapy and new: GlucoTab basal insulin therapy (BOT/BIT: basal insulin-assisted oral or incretin therapy).
  • On the one hand, this therapy regimen is designed for geriatric persons with diabetes, whose blood sugar target values can be set depending on their health status. For people with diabetes, e.g. after newly initiated insulin therapy, basal insulin therapy may also be sufficient.
  • The blood glucose target range and the frequency of insulin titration are determined individually depending on the patient’s health status.
  • Blood glucose control is mainly achieved with a once-daily long-acting basal insulin (optionally in combination with oral antidiabetic drugs or incretins). Correction with short-acting supplemental insulin is only carried out in case of very high blood glucose levels.
  • To avoid a blood glucose increase during the day, bolus insulin can be prescribed once a day in the morning or with the largest meal – basal insulin plus (BOT+/BIT+) therapy.
• Different task types to reactivate decision support
  • Regular therapy adjustment with one of the two GlucoTab therapy algorithms may be performed by physicians and nurses (in role “nurse+”)
  • However, certain situations require a therapy evaluation, which must be carried out by a physician.
  • For therapy adjustment and therapy evaluation, different task types are now distinguished, and different symbols are displayed.
• Also when using a GlucoTab therapy algorithm (basal-bolus or basal insulin BOT/BIT therapy), free text comments on basal insulin or bolus insulin can now be entered, which are displayed to the nurse during medication administration.
• If, during medication administration, the suggested/displayed dose has been increased or decreased by the user, this adjustment is visualized in the therapy profile by arrows next to the administered dose. This makes it easier to see if the medication was administered as planned. Backdated drug administration is also highlighted.
• If significantly less or more insulin has been administered to a patient in GlucoTab basal bolus therapy since the last dose adjustment than was suggested by the system (i.e. if the suggested dose was always changed manually when administering the medication), then the daily insulin dose is not increased or reduced during therapy adjustment, even if blood glucose target values were not reached. The user is informed about this in a dialogue.
  This safety measure may be relevant if nurses are very cautious and administer less insulin than the system suggests. This prevents the prescribed insulin dose from being increased even though more insulin has already been prescribed than was administered to the patient (and vice versa).
• In addition to the pre-therapy, there is now also the possibility of planning a discharge therapy. A plan (possibly also for accompanying measures such as patient education) or a specific therapy for the discharge of the patient can be documented in a free text field.
• Further improvements:
  • When a basal insulin administration is suggested for the first time after starting an algorithm-assisted therapy, the system will advise that previous insulin doses may still be active, and the suggested dose may need to be reduced manually. (Basal insulin or premixed insulin administered before the start of therapy are not known and must therefore be considered manually).
  • The manual entry of a blood glucose measurement can now also be confirmed with the Enter key on the keyboard. The enter key must be pressed twice. First the entry is checked for correctness and completeness, and the second time the entry is saved.
  • An additional diabetes type “undiagnosed diabetes” can be selected during enrolment if blood glucose measurements are performed on the patient – for observation only.
  • Comments can now be added or edited also for blood glucose measurements performed with POCT or via the laboratory. If comments from the laboratory are available, they are displayed in a separate field in the measurement details
  • The list with verbal orders is now visible also for nurses. Acknowledgement of verbal orders must still be done by physicians.

GlucoTab® version 6.0 (March 2019)

• GlucoTab is now also approved for the documentation of the therapy of patients with type 1 diabetes.
• Bolus calculator for intensive insulin therapy: dose calculation based on carbohydrate factor after input of carbohydrate exchange units and correction factor.
• Basal insulin can now be administered in basal bolus therapy at different times of the day. Up to now, the administration of long-acting insulin was only intended for noon in basal bolus therapy with decision support. Now the administration can also be prescribed in the evening and before going to bed.
• Presentation of the insulin daily dose in basal bolus therapy over time in the therapy plan during therapy adjustment
• Support of patient self-management:
  • If patients are marked as self-management patients, prescriptions of insulin with undetermined dose (X) are proposed because the patient himself defines the dose.
  • Of course, in this case no tasks for physicians are generated for the X orders.
  • Subsequent entry of blood glucose measurements and medication administered by the patient is possible.
• Prescription and presentation of the blood glucose measurement frequency are possible in the medication plan over time and in advance.
• Standardization of the user interface for nurses in different roles: Menu item therapy adjustment for entering verbal one-time orders for all nurses
• Improved presentation of prescriptions “every n days” in the medication plan
• Uniform sorting of medications in the therapy course, in the medication plan and during medication administration
• Display GFR value for evaluation of kidney function (patient’s most recent value available from laboratory).
• Double blood glucose values are only displayed once in the therapy profile. (e.g. if values are recorded manually when measuring with POCT device and received via laboratory)
• The prescribed blood glucose target range is displayed in the therapy course diagram
• Improved display of the prescribed insulin correction scheme by mouseover in the medication plan during prescription on the PC

GlucoTab® version 5.1 (October 2017)

In this release, various details of the documentation functionality and work process support have been improved to increase flexibility and further simplify use.

• Backdating of medication administrations for retrospective documentation (e.g. for self-management patients) is now possible.
• Free text comments in the therapy plan: The comments from blood sugar values and medication prescriptions are displayed for each day in the therapy plan. Furthermore, free text comments can be added and edited by all users.
• In addition to the prescribed drug dose, also the administered dose is displayed in the medication plan.
• Conversion of laboratory values by configuration: e.g. the HbA1c value can optionally be displayed in the “new” unit mmol/mol or the “old” unit %.
• Extension of the patient status information transmitted to the hospital information system: Patients with insulin therapy can be highlighted.
• Individually prescribed blood glucose measurements are visible in the therapy plan in a space-saving manner.