The Effect of Continuous Glucose Monitoring in Preventing Inpatient Hypoglycemia in General Wards: The Glucose Telemetry System

Spanakis, Elias K.; Levitt, David; Siddiqui, Tariq; Singh, Lakshmi G.; Pinault, Lillian F.; Sorkin, John D.; Umpiérrez, Guillermo E.; Fink, Jeffrey C.

doi:10.1177/1932296817748964

Cited by 55 publications

(56 citation statements)

References 31 publications

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“…POC glucose testing was not completely eliminated, and sensor values were used to aid in deciding corrective insulin coverage only. Our pilot data, although small in number, support the use of CGM in noncritically ill patients, similar to previous studies (1)(2)(3). We found efforts needed to be invested in ensuring smooth operation of the system.…”

supporting

confidence: 83%

Feasibility of Inpatient Continuous Glucose Monitoring During the COVID-19 Pandemic: Early Experience

et al. 2020

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Continuous glucose monitoring (CGM) systems have been explored in a few studies for non-intensive care unit (ICU) patients (1-3). During the coronavirus disease 2019 (COVID-19) pandemic, shortage of personal protective equipment (PPE) became a concern. On 1 April 2020, the U.S. Food and Drug Administration announced it would not object to the use of CGM systems to assist with COVID-19 patient monitoring (4). This study was conducted to explore the feasibility of using CGM in noncritically ill patients hospitalized with COVID-19. Non-ICU adult COVID-19-positive patients receiving subcutaneous insulin injection and point of care (POC) glucose testing (Accu-Chek Inform II) were eligible to participate. Exclusion criteria included unstable glucose levels (POC glucose ,70 or .350 mg/dL) at entry, hypotension, significant edema, being on dialysis, being postsurgical or with planned surgery/computed tomography/ MRI, and taking hydroxyurea, ascorbic acid, or acetaminophen .1 g every 6 h. Participants gave informed consent. The protocol was approved by the Institutional Review Board at the University of Illinois at Chicago.

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supporting

confidence: 83%

Feasibility of Inpatient Continuous Glucose Monitoring During the COVID-19 Pandemic: Early Experience

et al. 2020

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“…A remarkable consistency between CGM and BG measurements was reported without differences between groups, with 99% of data points in the clinically accurate or acceptable Clarke error grid zones, and the relative numbers of correctly identified episodes of glucose <3.9 and >13.9 mmol/L detected by CGM (sensitivity) were 47.3% and 81.5%, respectively. The number of hypoglycemic episodes (3.3 to <3.9 mmol/L) during nighttime detected by CGM (compared with values from the BG measurements) was 15-fold higher, and the number of episodes >13.9 mmol/L detected by CGM during nighttime was 12.5-fold higher (94) compared with capillary POC glucose testing in general medicine patients with T2D treated with a basal-bolus insulin regimen for ≥3 days. In addition, the use of CGM, compared with POC testing, uncovered a greater number of hypoglycemic events, and 60% of the episodes were during the night.…”

Section: Cgmmentioning

confidence: 95%

“…In addition, hypoglycemia alarms are only visible and audible at the bedside; as a result, nurses need to frequently enter the patient’s room to monitor glucose values on the CGM receiver. To overcome these limitations, a recent promising pilot study reported on the feasibility of a continuous glucose telemetry system in high hypoglycemia–risk patients in non-ICU settings (94). Elderly patients receiving high-dose insulin treatment and with multiple comorbidities were included in this study.…”

Section: Cgmmentioning

confidence: 99%

Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital

2018

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The use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems has gained wide acceptance in diabetes care. These devices have been demonstrated to be clinically valuable, improving glycemic control and reducing risks of hypoglycemia in ambulatory patients with type 1 diabetes and type 2 diabetes. Approximately 30–40% of patients with type 1 diabetes and an increasing number of insulin-requiring patients with type 2 diabetes are using pump and sensor technology. As the popularity of these devices increases, it becomes very likely that hospital health care providers will face the need to manage the inpatient care of patients under insulin pump therapy and CGM. The American Diabetes Association advocates allowing patients who are physically and mentally able to continue to use their pumps when hospitalized. Health care institutions must have clear policies and procedures to allow the patient to continue to receive CSII treatment to maximize safety and to comply with existing regulations related to self-management of medication. Randomized controlled trials are needed to determine whether CSII therapy and CGM systems in the hospital are associated with improved clinical outcomes compared with intermittent monitoring and conventional insulin treatment or with a favorable cost-benefit ratio.

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“…Spanakis et al . used CGM in general medicine in people with insulin‐treated Type 2 diabetes and the results were transmitted to a central nursing station monitoring system. An alarm system was set up at glucose <4.7 mmol/l.…”

Section: Prevention Of Inpatient Hypoglycaemiamentioning

confidence: 99%

Importance of inpatient hypoglycaemia: impact, prediction and prevention

et al. 2019

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Hypoglycaemia is a key barrier to achieving euglycaemic control in people who are hospitalized. Inpatient hypoglycaemia has been linked to adverse clinical outcomes, including mortality and longer stay in hospital. A number of studies have applied mathematical tools and statistical models to predict inpatient hypoglycaemia and identify factors that may result in hypoglycaemic events. Several different approaches have been tested to prevent inpatient hypoglycaemia. These can be categorized as human intervention, computerized methods or application of medical devices. In this review we provide an overview of the epidemiology of inpatient hypoglycaemia and its impact on patients and hospitals. We also discuss the existing methodology used to predict inpatient hypoglycaemia and the limited number of trials performed to prevent inpatient hypoglycaemia. The review highlights the urgent need for evidence‐based methods to reduce inpatient hypoglycaemia.

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The Effect of Continuous Glucose Monitoring in Preventing Inpatient Hypoglycemia in General Wards: The Glucose Telemetry System

Abstract: This pilot study indicates that the use of CGM values in hospitalized patients can be successfully transmitted to a monitoring device in the nursing station, improving patient surveillance in insulin treated patients with diabetes.

Cited by 55 publications

References 31 publications

Feasibility of Inpatient Continuous Glucose Monitoring During the COVID-19 Pandemic: Early Experience

Feasibility of Inpatient Continuous Glucose Monitoring During the COVID-19 Pandemic: Early Experience

Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital

Importance of inpatient hypoglycaemia: impact, prediction and prevention

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