Insulin Pump and Continuous Glucose Monitor Initiation in Hospitalized Patients with Type 2 Diabetes Mellitus

Levitt, David; Spanakis, Elias K.; Ryan, Kathleen A.; Silver, Kristi

doi:10.1089/dia.2017.0250

Cited by 22 publications

(20 citation statements)

References 49 publications

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“…A UK study of 80 000 examinees showed that several years are needed for intensification of medication treatment in type 2 diabetes patients, and the time range is longer when an insulin-dependent patient takes more different medications. Additional research in the UK has shown that many doctors delay changing a treatment, which can cause complications with diabetes and permanent consequences for the patient (e.g., cerebrovascular stroke, amputations, neuropathy, nephropathy, and retinopathy) [ 4 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Inertia in Type 2 Diabetes Patients in Primary Health Care Clinics in Central Bosnia

et al. 2018

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BackgroundThe goal of this research was to determine the frequency of clinical inertia of general practice physicians in the region of Central Bosnia in healthcare for type 2 diabetes patients, to analyze characteristics of patients and physicians, as well as glucose regulation during clinical inertia, and, on the basis of these indicators, give recommendations for reducing clinical inertia.Material/MethodsThis study included 29 doctors, family physicians, or general practitioners, who collected data in a total sample of 541 type 2 diabetes mellitus patients from July to November 2017. The research was conducted using 2 questionnaires. The glucose concentration in plasma and the percentage of glycosylated hemoglobin (HbA1c) were determined. Concertation of cholesterol, triglycerides, AST, and ALT were also measured. After the collection, new data were processed and the degree of clinical inertia was determined.ResultLevels of HbA1c ranged from 4.3% to 13.0%, and 38.4% of all patients had HbA1c level higher than 7.5%, while 8.3% of them had HbA1c level 9.0% or higher. Clinical inertia in our research was 12.6% out of all patients and 48.2% were referred to a specialist by their doctor.ConclusionsFor better regulation of glycemia and reduction of clinical inertia with type 2 diabetes patients, more specialized training is needed for selected physicians. Strengthening of primary healthcare and encouraging doctors to perform procedures can contribute to better outcomes of treatment, lower clinical inertia, and better education of patients.

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Section: Introductionmentioning

confidence: 99%

Clinical Inertia in Type 2 Diabetes Patients in Primary Health Care Clinics in Central Bosnia

et al. 2018

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“…Studies focusing or reporting on missing data are scarce. However, within controlled standardized settings or inpatient studies of short duration, a minimal loss of data has been reported ranging from 0 up to 24% when using various sensor technologies [5,34,[37][38][39][40][41][42]. The 4% of missing measurement nights correspond with those numbers and are within the 5% boundary for feasibility.…”

Section: Feasibilitymentioning

confidence: 92%

Feasibility of a Sensor-Based Technological Platform in Assessing Gait and Sleep of In-Hospital Stroke and Incomplete Spinal Cord Injury (iSCI) Patients

Hendriks

Hulst

Keijsers

2020

Sensors

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Recovery of the walking function is one of the most common rehabilitation goals of neurological patients. Sufficient and adequate sleep is a prerequisite for recovery or training. To objectively monitor patients’ progress, a combination of different sensors measuring continuously over time is needed. A sensor-based technological platform offers possibilities to monitor gait and sleep. Implementation in clinical practice is of utmost relevance and has scarcely been studied. Therefore, this study examined the feasibility of a sensor-based technological platform within the clinical setting. Participants (12 incomplete spinal cord injury (iSCI), 13 stroke) were asked to wear inertial measurement units (IMUs) around the ankles during daytime and the bed sensor was placed under their mattress for one week. Feasibility was established based on missing data, error cause, and user experience. Percentage of missing measurement days and nights was 14% and 4%, respectively. Main cause of lost measurement days was related to missing IMU sensor data. Participants were not impeded, did not experience any discomfort, and found the sensors easy to use. The sensor-based technological platform is feasible to use within the clinical rehabilitation setting for continuously monitoring gait and sleep of iSCI and stroke patients.

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“…Table 1 summarizes the literature for insulin pump therapy from the outpatient to inpatient setting, and initiation during a hospitalization. [18][19][20][21][22][23][24][25][26]…”

Section: Insulin Pump Management In the Inpatient Setting And Transmentioning

confidence: 99%

A guide for the pharmacist's role in insulin pump management during transitions of care

Clements

Castelli

Meade

et al. 2020

J Am Coll Clin Pharm

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In the United States, approximately 12% of the adult population has a diagnosis of diabetes mellitus (DM). Persons with DM are at a higher risk of microvascular and macrovascular complications, as well as hospitalizations, compared with the general population. Over the years, technology for diabetes management has evolved as approximately 350 000 patients are using insulin pump therapy to manage DM. Insulin pump therapy has been shown to improve glycemic control and lower the risk of safety events, such as hypoglycemia. Some studies have shown high compliance with an insulin pump policy among staff members during a hospitalization for a patient with an insulin pump. Other studies have shown improved glycemic control during hospitalization for patients who were managed on an insulin pump from an outpatient endocrinology clinic prior to admission. However, none of the studies involved pharmacy‐ or pharmacist‐led service for insulin pump management during transitions of care. Therefore, we defined the responsibilities of clinical pharmacists, in various roles, regarding insulin pump management in transitions of care. The purpose of this paper is to summarize current evidence for continuous subcutaneous insulin infusion (CSII) in transitions of care, including the use of insulin pumps in the hospital. Opportunities for a pharmacist's role in policies and procedures are also outlined, along with training of clinical pharmacists in this area of practice.

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Insulin Pump and Continuous Glucose Monitor Initiation in Hospitalized Patients with Type 2 Diabetes Mellitus

Cited by 22 publications

References 49 publications

Clinical Inertia in Type 2 Diabetes Patients in Primary Health Care Clinics in Central Bosnia

Clinical Inertia in Type 2 Diabetes Patients in Primary Health Care Clinics in Central Bosnia

Feasibility of a Sensor-Based Technological Platform in Assessing Gait and Sleep of In-Hospital Stroke and Incomplete Spinal Cord Injury (iSCI) Patients

A guide for the pharmacist's role in insulin pump management during transitions of care

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