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J Diabetes Sci Technol. 2019 Nov 28:1932296819889640. doi: 10.1177/1932296819889640. [Epub ahead of print]

Continuous Glucose Monitoring in General Wards for Prevention of Hypoglycemia: Results From the Glucose Telemetry System Pilot Study.

Author information

1
Division of Diabetes and Endocrinology, Baltimore Veterans Affairs Medical Center, MD, USA.
2
Maryland Endocrine, PA, Columbia, MD, USA.
3
Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA.
4
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
5
Baltimore Veterans Affairs Medical Center GRECC (Geriatric Research, Education, and Clinical Center), MD, USA.
6
Baltimore Veterans Affairs Medical Center and Division of General Internal Medicine, University of Maryland School of Medicine, MD, USA.
7
Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.

Abstract

BACKGROUND:

Limited evidence is available about the use of continuous glucose monitoring (CGM) in general wards. In this pilot study we evaluated the use of the glucose telemetry system (GTS) using CGM technology and remote monitoring to prevent inpatient hypoglycemia in high-risk insulin-treated patients with type 2 diabetes (DM2).

METHODS:

A prospective, single-center, randomized pilot study was conducted to determine whether GTS can prevent inpatient hypoglycemia. Patients were randomized to standard of care with point-of-care glucose testing or to the intervention group with GTS. Both groups used CGM (blinded vs real time). Our primary goal was prevention of inpatient hypoglycemia.

RESULTS:

A total of 13 subjects completed the study: 7 in the standard of care and 6 in the intervention group. The hypoglycemia event rate was 0.20 ± 0.23 episodes/day in standard of care vs 0.07 ± 0.11 episodes/day in the intervention group (P = .31). Six hypoglycemic events occurred in the standard of care vs two in the intervention group. Percentage of time spent <70 mg/dL was 2.44% ± 3.86% vs 0.30% ± 0.39% (P = .54) and time spent <54 mg/dL was 0.29% ± 0.47% vs 0% (P = .19) in the standard-of-care and intervention groups, respectively.

CONCLUSIONS:

Utilizing GTS for DM2 insulin-treated patients in the general wards may be beneficial in reducing hypoglycemia. Based on the results of our pilot study we have initiated a large-scale randomized-controlled trial to further evaluate GTS in the general wards in patients with DM2 at high risk for inpatient hypoglycemia.

KEYWORDS:

continuous glucose monitoring; glucose telemetry; hypoglycemia; inpatient; type 2 diabetes

PMID:
31777280
DOI:
10.1177/1932296819889640

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