The landscape of maternal health and diabetes management reached a significant milestone on October 28, as Glooko, Inc., a prominent leader in the global digital health sector, unveiled comprehensive real-world data regarding its glycemic safety and insulin dosing technologies. Presented at the prestigious Diabetes Technology Society (DTS) meeting, the findings centered on the clinical performance of EndoTool IV, a sophisticated computerized intravenous insulin dosing application, specifically within the high-stakes environment of labor and delivery (L&D) units. This announcement comes at a time when the healthcare industry is increasingly prioritizing the integration of digital tools to bridge the gap between ambulatory care and inpatient management.
The data, encapsulated in a research poster titled “Use of a Computerized Intravenous Insulin Dosing Application in Pregnancy,” provides a rigorous evaluation of outcomes among pregnant individuals who required intravenous insulin during the peripartum period. For clinicians, the labor and delivery phase represents one of the most complex challenges in glycemic management, as the body undergoes rapid physiological shifts that can cause blood glucose levels to fluctuate wildly, necessitating a delicate balance between treating hyperglycemia and preventing life-threatening hypoglycemia.
A Retrospective Analysis of Real-World Outcomes
The study presented by Glooko was a retrospective analysis that leveraged the 2025 EndoTool IV database, drawing from a substantial sample size of 267 individuals. These patients were treated across 43 different healthcare facilities, providing a broad geographical and institutional cross-section that enhances the reliability and generalizability of the findings. The primary objective of the analysis was to compare the effectiveness of the computerized dosing system across different types of diabetes, specifically contrasting individuals with Type 1 diabetes against those diagnosed with gestational diabetes mellitus (GDM) or Type 2 diabetes.
Managing blood glucose during labor is notoriously difficult because insulin sensitivity can change within minutes. During the active phase of labor, the physical exertion acts similarly to intense exercise, often lowering blood sugar. Conversely, the stress hormones released during delivery—such as cortisol and adrenaline—can drive glucose levels upward. Once the placenta is delivered, insulin resistance typically drops precipitously, creating a high risk for postpartum hypoglycemia. The EndoTool IV system is designed to navigate these rapid transitions using predictive algorithms that adjust insulin doses based on real-time patient data.
The findings from the analysis were overwhelmingly positive. Across all 267 cases, the system demonstrated an ability to maintain tight glycemic control within the target ranges established by the clinical teams. Perhaps most importantly, the data revealed zero instances of severe hypoglycemia among the patients evaluated. This safety profile is particularly significant in a labor and delivery context, where severe hypoglycemia can lead to maternal seizures, loss of consciousness, and potential fetal distress.
Clinical Perspectives on Personalized Dosing
Expert commentary accompanying the data release highlighted the practical implications for hospital care teams. Joseph Aloi, MD, a member of the Endocrine Society and Section Chief of Endocrinology and Metabolism at Advocate Health, Wake Forest University School of Medicine, emphasized the unique demands placed on clinicians during childbirth.
“Labor and delivery represents a uniquely dynamic period for glycemic management, when insulin requirements can change quickly and clinicians need to maintain tight glucose targets while minimizing the risk of hypoglycemia,” Dr. Aloi stated. He noted that the real-world findings are encouraging because they validate that personalized, algorithmic dosing can provide the level of precision necessary to support this vulnerable population.
In traditional hospital settings, insulin dosing is often managed via manual “sliding scales” or standardized paper protocols. These methods are frequently reactive rather than proactive, meaning they address high blood sugar after it has already occurred rather than predicting and preventing it. By using a computerized system like EndoTool IV, nursing staff can reduce the cognitive load and the margin for human error, ensuring that patients receive the exact amount of insulin required by their specific metabolic state at any given moment.
The Continuity of Care: From Pregnancy to Postpartum
Glooko’s strategy extends beyond the walls of the hospital. The company’s broader vision involves a “connected glycemic management” approach that follows the patient through every stage of their pregnancy journey. This journey typically involves three distinct phases: outpatient monitoring during the second and third trimesters, inpatient management during labor and delivery, and the critical transition to postpartum care.
To support the first and third phases, Glooko recently expanded its ambulatory platform with the introduction of GestationalCare™. This pregnancy-specific module is designed to assist care teams in reviewing complex fasting and post-meal glucose patterns. By providing a centralized dashboard for patient data, the module helps clinicians identify high-risk patients who may require more frequent interventions or adjustments to their treatment plans.
The integration of GestationalCare™ for outpatient use and EndoTool IV for inpatient use represents a significant step toward reducing the fragmentation of care. Mark Clements, MD, PhD, Chief Medical and Strategy Officer at Glooko, explained that diabetes management does not begin or end at the hospital door.
“A person may need close outpatient monitoring throughout pregnancy, precise insulin management during labor and delivery, and continued support as her care transitions postpartum,” Dr. Clements remarked. He argued that the recent data reinforces the potential of these tools to provide a seamless flow of information between different clinical teams, ensuring that the patient’s history and current needs are always at the forefront of decision-making.
Addressing the Growing Prevalence of Gestational Diabetes
The timing of Glooko’s data presentation is critical, given the rising prevalence of diabetes in pregnancy worldwide. According to recent health statistics, gestational diabetes affects approximately 6% to 10% of pregnancies in the United States alone. Furthermore, an increasing number of individuals enter pregnancy with pre-existing Type 1 or Type 2 diabetes.
Poorly managed blood glucose during pregnancy and delivery is associated with a range of complications, including macrosomia (excessive birth weight), which can lead to birth injuries or the need for Cesarean sections. Additionally, infants born to mothers with poorly controlled diabetes are at a higher risk of neonatal hypoglycemia and respiratory distress syndrome. By stabilizing maternal glucose levels during the peripartum period, technologies like EndoTool IV directly contribute to better neonatal outcomes and shorter hospital stays for both mother and child.
Industry Implications and the Future of Digital Health
The success of Glooko’s EndoTool IV in the L&D environment reflects a broader trend in the pharmaceutical and medical device industries toward "software as a medical device" (SaMD). As healthcare systems struggle with staffing shortages and increasing patient complexity, there is a growing demand for automated systems that can act as a "second pair of eyes" for bedside clinicians.
The Diabetes Technology Society meeting, where this data was presented, serves as a hub for innovation in the field. The inclusion of Glooko’s real-world data in this forum underscores the company’s commitment to evidence-based digital health. Industry analysts suggest that the shift toward connected platforms will likely force a consolidation of data, where disparate devices—such as continuous glucose monitors (CGMs), insulin pumps, and hospital dosing software—must communicate effectively to ensure patient safety.
Furthermore, the focus on the "fourth trimester"—the postpartum period—is an area of increasing interest for healthcare policy makers. The transition from the hospital back to the home is often where care gaps occur. Glooko’s ability to transition data from the EndoTool system back to the ambulatory GestationalCare™ module allows for a smoother handoff, ensuring that primary care physicians and outpatient endocrinologists have a clear picture of what occurred during the hospital stay.
Conclusion: A New Standard for Glycemic Safety
The presentation of the EndoTool IV data at the DTS meeting marks a pivotal moment for obstetric and endocrine care. By demonstrating that computerized insulin dosing can achieve tight glycemic control without a single instance of severe hypoglycemia in a diverse, real-world population, Glooko has provided a compelling argument for the adoption of such technologies in labor and delivery units nationwide.
As Dr. Clements noted, pregnancy is a powerful example of why a connected platform matters. The clinical needs of the patient change with extraordinary speed, but the requirement for timely data and coordinated decision-making remains a constant. By expanding its capabilities across both ambulatory and inpatient care, Glooko is positioning itself as a central player in the effort to reduce fragmentation and support a more consistent, data-driven approach to diabetes management.
The findings from the 2025 EndoTool IV database suggest that the future of maternal health will be defined by such innovations—where technology does not replace the clinician, but rather empowers them with the insights and precision necessary to manage the most dynamic and critical moments of human health. As more facilities adopt these digital solutions, the standard of care for pregnant individuals with diabetes is likely to reach new heights of safety and effectiveness, ultimately improving the lives of mothers and their newborns.
