Introduction: During a pandemic, use of remote monitors may reduce close patient contact and decrease risk of occupational exposure. This study evaluated the impact of continuous glucose monitor (CGM) use on the number of close encounters required for diabetes management in pregnant individuals. Methods: This study included 24 pregnant people with pregestational diabetes or medication-controlled gestational diabetes admitted for antepartum care. Participants received a Dexcom G6 CGM and were randomized to clinical use of CGM (intervention) or to standard care with fingerstick point-of-care (POC) glucose checks and a CGM device in blinded mode (control). The primary outcome was the number of POC glucose measurements per nursing shift. Secondary outcomes included glycemic control, neonatal outcomes, and patient and nursing satisfaction measured with surveys. Results: Patients in the intervention group required fewer POC measurements per shift than the control group, but this difference did not reach statistical significance (1.56 ± 0.88 vs 2.28 ± 1.17, p=0.08). Time in the pregnancy-recommended glycemic range (63-140 mg/dL) was similar in both the intervention and the control groups (77.65% ± 22.95 vs. 73.30% ± 27.23, p = 0.89). Time above range (21.64% ± 23.49 vs. 24.84% ± 27.82, p = 0.95) and below range (0.70% ± 1.58 vs. 1.86% ± 4.93, p = 0.64) were also comparable in the intervention and control patients. Neonatal intensive care unit (NICU) admission, neonatal hypoglycemia, hyperbilirubinemia and supplemental oxygen were less likely in the intervention group, however this difference was not significant when adjusted for gestational age at delivery. Patient and nursing satisfaction was high in both groups and not significantly different. Conclusion: Although use of CGM's for antepartum admissions did not significantly decrease close patient contact, equivalent glycemic control was achieved as with standard care. Neonatal outcomes were also similar in both groups. Disclosure J. Grasch: Research Support; Dexcom, Inc., TrueRelief, LLC. N. Nandam: None. E. Buschur: Consultant; Beta Bionics, Inc., Research Support; Dexcom, Inc., JDRF, Leona M. and Harry B. Helmsley Charitable Trust. Funding Dexcom, Inc. (IIS-2020-052)
The coronavirus disease 2019 pandemic resulted in the need for remote glucose monitoring in intensive care unit (ICU) patients requiring insulin infusions. While rarely reported, perceptions from nursing staff are critical for successful implementation and expanded use. A hybrid continuous glucose monitoring (CGM) and intermittent point of care (POC) glucose monitoring was developed at the study institution. After 1.5 years of protocol use, an anonymous survey was distributed electronically to ICU nurses to obtain their perspectives on CGM utilization. The survey employed a 1-5 Likert scale regarding CGM sensor insertion, accuracy, acceptability, and usability as well as perceptions on reduced room entry and reduced workload. Of the 51 surveys completed, 50 (98%) nurses reported they cared for an ICU patient enrolled in the CGM protocol and 31 (62%) started or replaced a CGM sensor. A representative sample of questions and responses is shown in table 1. ICU nurses overwhelmingly reported CGM was accurate, reduced their workload, provided safer patient care, and was preferred over POC glucose testing alone. These results confirm nursing acceptance and preference for CGM use within a hybrid glucose monitoring protocol in the ICU setting. Disclosure J. Pattison: None. K. M. Dungan: Advisory Panel; Dexcom, Inc., Consultant; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Elsevier, Nova Biomedical, Novo Nordisk, Tolerion, Inc., Other Relationship; UpToDate, Research Support; Abbott, Dexcom, Inc., Novo Nordisk, Sanofi, ViaCyte, Inc., Speaker’s Bureau; Academy for Continued Healthcare Learning, Cardiometabolic Health Congress, Medscape. E. Buschur: Advisory Panel; Beta Bionics, Inc., Research Support; Dexcom, Inc. M. C. Exline: Other Relationship; Abbott. L. G. Jones: None. C. May: None. M. Mcnett: None. K. Smetana: None. E. R. Faulds: Advisory Panel; Dexcom, Inc., Research Support; Dexcom, Inc., Speaker’s Bureau; Medscape.
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