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

Abstract

Background: Few studies have examined the use of continuous glucose monitoring (CGM) devices in the general wards. The aim of this pilot study was to examine whether CGM readings can be successfully transmitted from the bedside to a central monitoring device in the nursing station, and whether a glucose telemetry system can prevent hypoglycemic events.

Methods: We present pilot data on 5 consecutive insulin treated general medicine patients with type 2 diabetes (T2DM) whose glucose values were observed with CGM (DEXCOM) and the results were transmitted to a central nursing station monitoring system using DEXCOM Follow and Share 2 software. CGM alarms were set-up at glucose <85 mg/dl.

Results: Duration of CGM observation was 4.0 ± 1.6 days (mean ± SD). During CGM, the overall time spent within blood glucose (BG) target of 70-179 mg/dl was 64.68 ± 15% (mean ± SD), on hypoglycemia (<70 mg/dl) was 0.30% ± 0.39, and time spent on hyperglycemia (≥180 mg/dl) was 35.02% ± 15.5. Two patients had 3 actions of prevention of potential hypoglycemia (CGM BG <70 mg/dl for >20 minutes) captured by alarm. No patients had CGM glucose value <54 mg/dl.

Conclusions: 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.

Keywords: CGM; continuous glucose monitoring; glucose telemetry; hypoglycemia; inpatient; type 2 diabetes.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: EKS has received research support (CGM supplies) that were needed for the conduction of the study. JS was supported by P30AG028747, P30DK072488, and by the Baltimore Geriatrics Research, Education and Clinical Center. GEU is partly supported by research grants Public Health Service Grant UL1 RR025008 from the Clinical and Translational Science Award program, and 1P30DK111024-01 from the National Institutes of Health and National Center for Research Resources. GEU has received unrestricted research support for inpatient studies (to Emory University) from Merck, Novo Nordisk, AstraZeneca, Boehringer Ingelheim, and Sanofi. JCF is partially supported by research grants from the National Institutes of Health: R34DK102177-01, R01 HL127422, and R18 DK110955.

Figures

Figure 1.

Description of glucose telemetry system (GTS).