Study Data Show EndoTool’s Ability to Drastically Reduce Severe Hypoglycemia

Glooko Inc. is touting favorable study results indicating that its EndoTool IV reduced severe hypoglycemia by 98% across a large, 19-hospital health system as compared with historical protocols.

The company interpreted the data from a three-year retrospective analysis (January 2023 to December 2025) that included 17,838 patients and 362,901 blood glucose values. Titled, “Virtual Elimination of Severe Hypoglycemia Utilizing a Computerized Insulin Dosing Algorithm for Intravenous Insulin Infusions,” the analysis showed severe hypoglycemia (blood glucose less than 40 mg/dl) incidence dropping to 0.005% (18 readings) compared with 0.23% under paper protocols. Among 4,804 patients managed with diabetic ketoacidosis (DKA)-specific protocols, severe hypoglycemia incidence was 0.007%. In patients with severe renal impairment (eGFR <15), the incidence of severe hypoglycemia was 0.007%, compared with 0.005% in patients with eGFR >60. The analysis also found EndoTool IV recommended prophylactic carbohydrates, which helped avoid 2,213 potential episodes of hypoglycemia, while severe hyperglycemia (blood glucose greater than 300 mg/dl) remained low at 0.17%.

“Severe hypoglycemia is one of the most consequential risks in inpatient insulin management, especially in patients with impaired kidney function,” said Joseph Aloi, M.D., section chief, Endocrinology and Metabolism at Advocate Health Wake Forest Baptist Hospital. “What makes this data compelling is that we saw consistently low rates of severe hypoglycemia across a large real-world hospital population, including patients with severe renal impairment, while maintaining control of severe hyperglycemia.”

The findings reinforce EndoTool’s value proposition around patient-specific insulin dosing, powered by a multivariable model that incorporates key clinical factors such as renal function, steroid use, and estimated residual extracellular insulin (EREI), according to the company. This approach is complemented by proactive carbohydrate recommendations when hypoglycemia appears imminent and therapy modes designed for complex inpatient scenarios such as DKA, HHS, and euglycemic DKA.

“These data reinforce an important point for healthcare systems: safer inpatient glycemic management requires more than static protocols,” stated Paul Chidester, M.D., medical director, EndoTool, at Glooko. “Hospitals need decision support that reflects how individual patients respond to insulin. EndoTool’s patient-specific dosing helps standardize care, reduce risk, and support frontline teams as glycemic safety becomes a more visible measure of performance.”

As hospitals face increasing scrutiny around performance on severe hypoglycemia and hyperglycemia, these data provide timely evidence that more precise inpatient insulin dosing can improve safety at scale while reducing burden at the bedside, including 55% fewer glucose checks and a 75% increase in nursing satisfaction.^1,2

Glooko is a global digital health company helping address the growing challenges of glycemic safety and diabetes management across the care continuum. Glooko is attempting to be an enterprise partner to healthcare providers seeking to reduce glycemic risk, improve safety, and support overburdened clinical teams with coordinated expertise across both outpatient and inpatient care settings.

EndoTool is developed and marketed by Monarch Medical Technologies LLC, a Glooko company, and is a separate solution from the Glooko diabetes management platform.

References
¹ Salim, K., Gomes, J., Calderon Martinez, E., Abedeen, D., Scheid, Z., Riaz, R., Ortiz, L., Schrader, A., Helmuth, A., Srivastav, S., Chidester, P., & Atrash, A. (2023). Evaluating the effect of EndoTool utilization for glycemic control in critically ill patients at UPMC Central Pennsylvania [Poster presentation]. 23rd Annual Diabetes Technology Meeting. https://monarchmedtech.com/wp-content/uploads/2023/11/UPMC-DST-Poster.pdf
² Dumont, C., & Bourguignon, C. (2012). Effect of a computerized insulin dose calculator on the process of glycemic control. American Journal of Critical Care, 21(2), 106–115. https://doi.org/10.4037/ajcc2012956