Round Table Discussion on Inpatient Use of Continuous Glucose Monitoring at the International Hospital Diabetes Meeting

Investigators, Pride

doi:10.1177/1932296816656380

Cited by 26 publications

(25 citation statements)

References 28 publications

(40 reference statements)

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“…41 However, expert opinion suggests that CGM may be appropriate for specific high-risk groups, such as patients with cardiovascular disease in the non-ICU setting. 42 In our study, CGM detected more occult hypoglycemia episodes than capillary glucose testing, validating the results of prior inpatient CGM studies. [27][28][29] Contrary to outpatient studies demonstrating glycemic benefit, 43,44 inpatient nonblinded CGM use did not result in decreased mean glucose compared with blinded CGM in our study.…”

Section: Discussionsupporting

confidence: 88%

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

Levitt

Spanakis

Ryan

et al. 2018

Diabetes Technology & Therapeutics

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Section: Discussionsupporting

confidence: 88%

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

Levitt

Spanakis

Ryan

et al. 2018

Diabetes Technology & Therapeutics

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“…Usage of CGM in the hospitalized patient and in the ICU remains a work in progress. 49,50 There has been considerable interest in the use of CGM in the hospitalized patient to assist with glycemic control in patients continuing the therapies they used as an outpatient, for control of insulin infusions, and for use in the intensive care unit. The continuing improvement in the accuracy, robustness, and usability of CGM sensors offers considerable promise for an increasing role for the hospitalized patient.…”

Section: Cgm Studies In Special Populationsmentioning

confidence: 99%

Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes

Rodbard¹

2017

Diabetes Technology & Therapeutics

357

267

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Continuous Glucose Monitoring (CGM) has been demonstrated to be clinically valuable, reducing risks of hypoglycemia and hyperglycemia, glycemic variability (GV), and improving patient quality of life for a wide range of patient populations and clinical indications. Use of CGM can help reduce HbA1c and mean glucose. One CGM device, with accuracy (%MARD) of approximately 10%, has recently been approved for selfadjustment of insulin dosages (nonadjuvant use) and approved for reimbursement for therapeutic use in the United States. CGM had previously been used off-label for that purpose. CGM has been demonstrated to be clinically useful in both type 1 and type 2 diabetes for patients receiving a wide variety of treatment regimens. CGM is beneficial for people using either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). CGM is used both in retrospective (professional, masked) and real-time (personal, unmasked) modes: both approaches can be beneficial. When CGM is used to suspend insulin infusion when hypoglycemia is detected until glucose returns to a safe level (low-glucose suspend), there are benefits beyond sensor-augmented pump (SAP), with greater reduction in the risk of hypoglycemia. Predictive low-glucose suspend provides greater benefits in this regard. Closed-loop control with insulin provides further improvement in quality of glycemic control. A hybrid closed-loop system has recently been approved by the U.S. FDA. Closed-loop control using both insulin and glucagon can reduce risk of hypoglycemia even more. CGM facilitates rigorous evaluation of new forms of therapy, characterizing pharmacodynamics, assessing frequency and severity of hypo-and hyperglycemia, and characterizing several aspects of GV.

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“…Interestingly, the use of CGM technology for glucose monitoring was inversely associated with both hyperglycemia and hypoglycemia among respondents with type 1 DM. In comparison, in numerous other experimental and observational studies, the use of CGM was associated with improved glycemic control [79,80,81]. CGM plays an important role in successful glycemic control by helping patients to timely and effectively detect and counteract hyperglycemia and hypoglycemia.…”

Section: Discussionmentioning

confidence: 97%

The Role of Continuous Glucose Monitoring, Diabetes Smartphone Applications, and Self-Care Behavior in Glycemic Control: Results of a Multi-National Online Survey

Kebede

Schuett

Pischke

2019

JCM

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Background: This study investigated the determinants (with a special emphasis on the role of diabetes app use, use of continuous glucose monitoring (CGM) device, and self-care behavior) of glycemic control of type 1 and type 2 diabetes mellitus (DM). Methods: A web-based survey was conducted using diabetes Facebook groups, online patient-forums, and targeted Facebook advertisements (ads). Demographic, CGM, diabetes app use, and self-care behavior data were collected. Glycemic level data were categorized into hyperglycemia, hypoglycemia, and good control. Multinomial logistic regression stratified by diabetes type was performed. Results: The survey URL was posted in 78 Facebook groups and eight online forums, and ten targeted Facebook ads were conducted yielding 1854 responses. Of those owning smartphones (n = 1753, 95%), 1052 (62.6%) had type 1 and 630 (37.4%) had type 2 DM. More than half of the type 1 respondents (n = 549, 52.2%) and one third the respondents with type 2 DM (n = 210, 33.3%) reported using diabetes apps. Increased odds of experiencing hyperglycemia were noted in persons with type 1 DM with lower educational status (Adjusted Odds Ratio (AOR) = 1.7; 95% Confidence Interval (CI): 1.21–2.39); smokers (1.63, 95% CI: 1.15–2.32), and high diabetes self-management concern (AOR = 2.09, 95% CI: 1.15–2.32). CGM use (AOR = 0.66, 95% CI: 0.44–1.00); “general diet” (AOR = 0.86, 95% CI: 0.79–0.94); and “blood glucose monitoring” (AOR = 0.88, 95%CI: 0.80–0.97) self-care behavior reduced the odds of experiencing hyperglycemia. Hypoglycemia in type 1 DM was reduced by using CGM (AOR = 0.24, 95% CI: 0.09–0.60), while it was increased by experiencing a high diabetes self-management concern (AOR = 1.94, 95% CI: 1.04–3.61). Hyperglycemia in type 2 DM was increased by age (OR = 1.02, 95% CI: 1.00–1.04); high self-management concern (AOR = 2.59, 95% CI: 1.74–3.84); and poor confidence in self-management capacity (AOR = 3.22, 2.07–5.00). Conversely, diabetes app use (AOR = 0.63, 95% CI: 0.41–0.96) and “general diet” self-care (AOR = 0.84, 95% CI: 0.75–0.94), were significantly associated with the reduced odds of hyperglycemia. Conclusion: Diabetes apps, CGM, and educational interventions aimed at reducing self-management concerns and enhancing dietary self-care behavior and self-management confidence may help patients with diabetes to improve glycemic control.

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Round Table Discussion on Inpatient Use of Continuous Glucose Monitoring at the International Hospital Diabetes Meeting

Cited by 26 publications

References 28 publications

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

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

Continuous Glucose Monitoring: A Review of Recent Studies Demonstrating Improved Glycemic Outcomes

The Role of Continuous Glucose Monitoring, Diabetes Smartphone Applications, and Self-Care Behavior in Glycemic Control: Results of a Multi-National Online Survey

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