In inpatient glycemic management, the challenge is not simply lowering glucose. It is doing so without causing harm. That is why new EndoTool IV data being presented at the American Association of Clinical Endocrinology (AACE) Annual Meeting 2026 matter: across 19 hospitals, severe hypoglycemia fell 98% versus paper protocols, while severe hyperglycemia remained low at 0.17%.
The poster reports a three-year retrospective analysis from January 2023 through December 2025, covering 17,838 patients and 362,901 blood glucose values. Severe hypoglycemia incidence dropped to 0.005% compared with 0.23% under historical paper protocols. In 4,804 patients treated through DKA-specific protocols, severe hypoglycemia incidence was only 0.007%. Just as important, the analysis found that 2,213 potential episodes of hypoglycemia were avoided because EndoTool IV recommended prophylactic carbohydrates before blood glucose dropped below 70 mg/dL.
One of the most compelling parts of the poster is the renal story. Patients with severe renal impairment are often among the most difficult and highest-risk populations in inpatient insulin management. In this analysis, patients with eGFR <15 had a severe hypoglycemia incidence of 0.007%, compared with 0.005% in patients with eGFR >60. That finding aligns closely with EndoTool’s approved differentiation around patient-specific dosing, residual insulin calculation, and support for safer dosing in patients with reduced renal function.
This is where the “so what” becomes clear. Hospitals are facing more pressure to improve glycemic safety, and severe hypoglycemia and hyperglycemia are more visible quality concerns than they were even a few years ago. A tool that can help reduce patient harm, support more standardized insulin dosing, and give teams more confidence in complex cases is not just clinically useful – it is strategically relevant.
The EndoTool message has long been that inpatient insulin management should be safer, simpler, and more standardized. EndoTool is patient-specific, capable of adjusting for kidney function and steroid use, and able to recommend proactive carbohydrate interventions when hypoglycemia appears imminent. This can lead to reduced cognitive burden for clinicians, more consistent protocols, and better support for frontline teams. This new poster gives that story fresh, real-world, health-system-scale evidence.
The bigger takeaway is this: hospitals should not have to choose between reducing hypoglycemia and maintaining glycemic control. These data suggest that patient-specific insulin dosing can help achieve both. And in today’s environment, that is a story worth paying attention to.
EndoTool is developed and marketed by Monarch Medical Technologies, a Glooko Company. EndoTool is an FDA-cleared Class II medical device indicated for inpatient use as described in its Instructions for Use. Glooko’s diabetes management platform and EndoTool are currently independent solutions. Patient-specific refers to EndoTool’s ability to use available patient information within the hospital’s electronic medical record to provide individualized insulin dosing recommendations. Recommendations are intended to assist, not replace, clinical judgment. All treatment decisions remain the responsibility of the licensed healthcare provider.