{"id":129294,"date":"2026-02-26T02:00:00","date_gmt":"2026-02-26T08:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/?p=129294"},"modified":"2026-02-24T08:53:43","modified_gmt":"2026-02-24T14:53:43","slug":"unmc-teams-new-protocol-improves-surgical-glucose-control","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2026\/02\/26\/unmc-teams-new-protocol-improves-surgical-glucose-control\/","title":{"rendered":"UNMC team’s new protocol improves surgical glucose control"},"content":{"rendered":"
\n

A new study led by UNMC investigators shows that embedding a standardized glucose management protocol into the electronic health record can help perioperative care teams better control blood sugar levels for patients with diabetes.<\/p>\n\n\n\n

The study<\/a>, published in the Journal of Diabetes Science and Technology, evaluated more than 1,200 adults with diabetes who underwent non-cardiac surgery before and after the EHR-embedded protocol launched in 2023. The study found a significant improvement in glucose control during surgery and a reduction in preoperative hypoglycemia, all without increasing complications.<\/p>\n\n\n\n

\u201cThe idea grew out of a recognition that perioperative dysglycemia was both common and difficult to address,\u201d said Troy Wildes, MD, vice chair of perioperative medicine, quality and safety at the UNMC Department of Anesthesiology. \u201cDespite national guidelines, there was no unified, real-time approach built into our everyday workflow. We saw an opportunity to standardize care, reduce practice variability and address monitoring gaps by embedding guidance directly within the EHR.\u201d<\/p>\n\n\n\n

This multidisciplinary study was spearheaded by Andjela Drincic, MD, professor at the UNMC Division of Diabetes, Endocrinology and Metabolism, with contributions from hospital medicine, anesthesiology, nursing, pharmacy and information technology. The protocol provides clear direction for glucose monitoring and insulin administration before, during and after surgery.<\/p>\n\n\n\n

Melissa McKnight, PharmD, credited the project\u2019s success to its multidisciplinary design. \u201cCollaboration was absolutely vital,\u201d she said. \u201cSurgery and anesthesia workflows are very different from standard inpatient care. Working closely with endocrinology and diabetes specialists allowed us to adapt inpatient diabetes tools to the unique, time-sensitive challenges of the perioperative setting.\u201d<\/p>\n\n\n\n

Dr. McKnight, who helped develop the protocol, said building a process that worked for most surgical patients while still allowing flexibility was key. \u201cWe needed to make sure the protocol was usable in high-risk case like those in patients with type 1 diabetes while minimizing alert fatigue and keeping it practical for busy clinicians,\u201d she said.<\/p>\n\n\n\n

Embedding the protocol directly into the EHR made the process easier for clinicians.<\/p>\n\n\n\n

\u201cInstead of searching for separate documents or relying on memory, anesthesia teams could access glucose-monitoring intervals and insulin guidance within the exact order sets they already use,\u201d Dr. Wildes said. \u201cIt simplified daily practice, reduced the cognitive load and helped new team members quickly understand expectations.\u201d<\/p>\n\n\n\n

Shubham Agarwal, MD, assistant professor at the UNMC Division of Diabetes, Endocrinology and Metabolism, noted the team\u2019s approach demonstrates the feasibility of digitized, evidence-based care pathways. \u201cOur findings show that standardizing perioperative glycemic care through embedded decision support is both practical and impactful,\u201d he said. \u201cIt provides a framework for other hospitals looking to deliver consistent, high-quality care in complex, fast-moving clinical settings.\u201d<\/p>\n\n\n\n

Better glucose control is associated with fewer surgical site infections, improved wound healing and shorter recoveries, outcomes that the team hopes to study further. \u201cEven though our project wasn\u2019t designed to measure long-term outcomes, improving the underlying processes of care is expected to lead to better recovery and safety,\u201d Dr. Wildes said.<\/p>\n\n\n\n

The team is working on imminent expansion to the Bellevue Medical Center campus and sees broader potential for similar EHR-based decision tools. \u201cThis approach can be helpful anywhere complex, rapid decisions are made, from inpatient glycemic management to other aspects of perioperative and critical care,\u201d Dr. Wildes said.<\/p>\n\n\n\n

For Dr. Agarwal, the project represents the spirit of UNMC\u2019s innovative culture.<\/p>\n\n\n\n

\u201cAnything we can do to automate care and reduce the mental burden on providers helps us deliver safer, more consistent care,\u201d he said. \u201cThis work reflects UNMC\u2019s iTEACH values — innovation, teamwork and excellence — by showing how collaboration and technology can improve outcomes for patients across Nebraska and beyond.\u201d<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

A study shows the benefits of embedding a standardized glucose monitoring protocol into the electronic health 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