UC Davis Health improves inpatient diabetes care with team approach that puts safety first

UC Davis Health has significantly and sustainably improved inpatient glycemic care through a coordinated, system-wide approach.

Those findings come from a study published in Diabetes, Obesity, and Cardiometabolic Care, a journal of the American Diabetes Association. The article describes how UC Davis Health developed and implemented a multidisciplinary inpatient glycemic management model that improved blood glucose outcomes across the medical center without increasing hypoglycemia - a critical patient safety concern in hospitalized populations.

"Improving inpatient diabetes care requires more than individual interventions. It takes a coordinated, system-wide commitment to patient safety, clinical excellence, and multidisciplinary collaboration," said Joseph M. Galante, chief medical officer, UC Davis Medical Center.

The study, he noted, demonstrates how teams across nursing, pharmacy, endocrinology, quality and frontline employees worked together to create a coordinated approach to care. They built a sustainable model that improved outcomes for hospitalized patients while reducing the risks associated with both hyperglycemia and hypoglycemia.

"It reflects UC Davis Health's ongoing commitment to delivering evidence-based, high-quality care through innovation and teamwork," Galante added.

A phased, system-wide strategy

The initiative was led by the Multidisciplinary Diabetes Care Committee (MDCC) and implemented over several years using a structured, phased approach. Rather than relying primarily on individual consultations, the program focused on strengthening institutional infrastructure and aligning clinical practices across disciplines.

Key components included:

• An active consult service: Inpatient Glycemic Team
• Standardized insulin order sets with embedded clinical decision support
• Multidisciplinary glucose management rounds
• Unit-based diabetes nurse champions
• An ICU insulin infusion protocol co-managed with pharmacists
• Glycemic data and insulin administration dashboards to track performance metrics
• Ongoing education for physicians, trainees, nurses, and allied health professionals

Measurable improvements in glycemic outcomes

During the study period, UC Davis Medical Center reduced clinically significant hyperglycemia while maintaining or improving rates of hypoglycemia. The percentage of inpatient days with average blood glucose levels above 180 mg/dL declined, and episodes of severe hyperglycemia were substantially reduced.

Importantly, the team achieved these gains without an increase in low-blood-glucose events. In fact, the rates of hypoglycemia and severe hypoglycemia decreased while overall glycemic control improved, reinforcing the safety of the approach.

"Our goal was never just to lower glucose values," said Deborah Kathleen Plante, professor of endocrinology and co-author of the article. "We focused on building a sustainable system that improves glycemic outcomes while protecting patients from harm. The data show that a structured, multidisciplinary approach can achieve both."

Advancing inpatient diabetes care

The study demonstrates how health systems can move from reactive glucose management to a more proactive, standardized model of inpatient care aligned with American Diabetes Association guidelines. By integrating data monitoring, clinical workflows and continuous education, UC Davis Health established a framework that supports consistent, high-quality care for hospitalized patients with diabetes or stress hyperglycemia.

While continued refinement is needed, the findings suggest that system-level investment in inpatient glycemic management can deliver durable improvements in both patient safety and quality of care.