Continuous Glucose Monitoring in the Hospital

Abstract

Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.

Evaluating perioperative glycemic status after different types of pancreatic surgeries via continuous glucose monitoring system: a pilot study

“…Nevertheless, neither the pathophysiology nor the pathogenesis behind it has been fully understood, and only a few studies have demonstrated the detailed glycemic variability after pancreatectomy. CGM device provides us a utility tool for glucose monitoring (13,28). Recently, there were two studies using CGM to investigate patients' glycemic status and variation long after the original pancreatic surgery (7,8).…”

The Role of the Diabetes Care and Education Specialist in the Hospital Setting

“…Hospitals may use a variety of different diabetes technology options, including computerized insulin infusion calculators and, most recently, continuous glucose monitors (CGMs). 46,47 Diabetes care and education specialists should be involved with development and/or oversight of policies and procedures for the use, maintenance, and related practice issues based on regulatory requirements and device manufacturers’ specifications. 47…”

“…46,47 Diabetes care and education specialists should be involved with development and/or oversight of policies and procedures for the use, maintenance, and related practice issues based on regulatory requirements and device manufacturers’ specifications. 47…”

More Green, Less Red: How Color Standardization May Facilitate Effective Use of CGM Data

“…7 In addition, many hospital systems use color coding to monitor glycemic status to visually characterize the measured BG values. With increasing use of CGM data measured, for example, in the intensive care unit, 8 there is also a movement toward displaying their metrics in color. 5 Again, some hospitals choose colors consistent with the AGP color code and others do not.…”