EndoTool SubQ
Overview
EndoTool SubQ, developed by Monarch Medical Technologies (now part of Glooko as of September 23, 2025), is a software application designed to provide clinical decision support for subcutaneous insulin administration. It is used to manage blood glucose levels in both adult and pediatric patients (age 2 years and above and 12 kg or more). The tool utilizes proprietary model predictive control technology and feedback mathematics to model, predict, and adjust to each patient’s unique physiology and individual response to insulin, recommending the safest, most effective patient-specific dose.
EndoTool SubQ considers various factors that impact insulin response, including blood glucose level, height, weight, type of diabetes mellitus, age, sex, creatinine levels, steroids, carbohydrate intake, and ordered insulin. The software aims to reduce and eliminate correctional dosing, promote mealtime dosing, and prevent hypoglycemia by recommending supplemental carbohydrates if needed. As part of the broader EndoTool platform, it facilitates safe and easy transitions between intravenous and subcutaneous insulin therapies. The technology originated in 2003 with MD Scientific, which laid the groundwork for the EndoTool glucose management system.
Reviewed by Pouyan Golshani, MD — Interventional Radiologist
Key Features
- Patient-specific insulin dosing recommendations
- Model predictive control technology
- Feedback mathematics for modeling and predicting insulin response
- Adjusts to individual patient physiology
- Considers various patient factors (BG, height, weight, diabetes type, age, sex, creatinine, steroids, carb intake, ordered insulin)
- Reduces and eliminates correctional dosing
- Promotes mealtime dosing
- Recommends supplemental carbohydrates for hypoglycemia prevention
- Supports adult and pediatric patients (age 2 and above)
- Seamless transition between IV and SubQ insulin therapies (as part of EndoTool platform)
Use Cases
- Inpatient subcutaneous insulin management
- Hyperglycemia treatment in hospitalized patients
- Hypoglycemia prevention in hospitalized patients
- Transitioning patients from IV to subcutaneous insulin therapy
- Standardizing insulin dosing protocols in hospitals
- Improving glycemic control and patient safety in hospitals
What Physicians Need to Know
Leverage EndoTool SubQ as a powerful decision *support* tool to individualize insulin dosing, moving beyond traditional sliding scales to achieve safer and more effective glycemic control. Pay close attention to the system's proactive alerts for hypoglycemia and utilize its analytics features to monitor adherence, identify workflow inefficiencies, and continuously refine your institution's glycemic management protocols, especially for high-risk patients like those with renal impairment or during transitions from IV to subcutaneous insulin.
EndoTool SubQ's proven ability to integrate seamlessly with major EMR systems is critical for maximizing its benefits. Ensure robust integration to enable automatic data exchange of patient demographics, lab values, and point-of-care glucose readings, which will streamline clinical workflows, reduce manual data entry errors, and provide a comprehensive, real-time view of patient glycemic status within your existing health IT infrastructure.
Details
| Category | Endocrinology & Metabolic AI, Pharmacology & Dosing AI |
| Pricing | Contact vendor |
| Deployment | Cloud-based (browser-based) and potentially thick client options. |
| Compliance | |
| BAA Available | Unknown AI-estimated |
| HIPAA Compliant | Unknown AI-estimated |
| FDA Status |
1 AI-estimated EndoTool SubQ received U.S. Food and Drug Administration (FDA) 510(k) clearance (K142918) on April 24, 2015. It is cleared for use by trained healthcare professionals to calculate and recommend an individual patient's next dose of insulin to be administered subcutaneously to manage blood glucose levels in adult and pediatric patients (age 2 and above and 12 kg or more). |
| Integrations | |
| EHR | Not specified |
| Specialties | Endocrinology, Hospital Medicine, Pediatrics |
What the Web Says
EndoTool SubQ is an FDA-cleared, patient-specific insulin dosing system designed to provide individualized insulin recommendations for subcutaneous insulin delivery in both adult and pediatric patients (age 2 and above). It utilizes advanced algorithms that consider various patient factors like blood glucose, height, weight, diabetes type, age, sex, creatinine levels, steroid use, and carbohydrate intake to recommend the safest and most effective dose. The system aims to improve glycemic control, reduce hypoglycemic and hyperglycemic events, and enhance clinician confidence in insulin dosing.
Overall: PositiveStrengths
- Significant reduction in hypoglycemic events (both mild and severe).
- Improved overall glycemic control and maintenance of target glucose ranges.
- Enhanced clinician (especially nurse) confidence in insulin dosing.
- Provides patient-specific, individualized insulin recommendations.
- Streamlined workflow and reduced need for manual adjustments.
- Ability to adjust recommendations rapidly in response to changes like missed meals or vomiting.
Limitations
- Requires extensive training and institution-wide adoption.
- Some initial studies showed no statistically significant difference in time to achieve target blood glucose or percentage of time within target range compared to paper protocols, although trends toward improved safety were noted.
- Limited published research specifically on subcutaneous insulin guidance compared to intravenous versions of similar systems.
- Some Reddit users mention it can be aggressive in bringing down blood glucose quickly, potentially overshooting.
- Can be time-intensive for nurses due to frequent blood sugar checks, especially in the initial phases.
Based on reviews from: Monarch Medical Technologies, Temple Health, PubMed, Reddit (r/nursing), American Diabetes Association
Last updated: 2026-07-19
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