Author: Julia Vetsikas
This feasibility study of critically ill patients with COVID19 in a single medical ICU (MICU) wearing Dexcom G6 concluded real-time continuous glucose monitoring (RT-CGM) systems can be successfully implemented in the MICU using a hybrid protocol implementation approach. Nurses indicated RT-CGM provided an overall time savings and decreased the time spent in COVID19 rooms
Faulds ER, et al. Facilitators and Barriers to Nursing Implementation of Continuous Glucose Monitoring (CGM) in Critically Ill Patients With COVID-19. Endocr Pract. 2021;27(4):354-361.
Learn MoreThis randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.
Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.
Learn MoreThis publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.
Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.
Learn MoreA clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia.
Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.
Learn More
The US Food and Drug Administration (FDA) approved the Omni Pod 5 tubeless insulin pump technology for individuals aged 2 years and older with type 1 diabetes (T1D). Omnipod 5 is the first tubeless, wearable automated insulin delivery (AID) system that integrates with the Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system and a compatible smartphone to automatically adjust insulin and help protect against both hyper- and hypoglycemia.
Learn MoreThe National Committee for Quality Assurance (NCQA) is revising its Healthcare Effectiveness Data and Information Set (HEDIS) standardized measures assessing plan performance for 2023. Notably, the 2023 dataset will include a new measure related to diabetes management: the risk-adjusted ratio of observed to expected emergency department visits for hypoglycemia among older adults (aged ≥67 years) with diabetes.
This measure reflects a key component of health plan quality pertaining to the management of diabetes, since older adults are more likely to experience severe hypoglycemia, potentially leading to several adverse outcomes: fall-related events and fractures, increased risk of cardiovascular events, and cognitive decline. Similarly, prevailing clinical practice guidelines for the treatment of older adults with diabetes emphasize the prevention of hypoglycemia as an important outcome. The new HEDIS measure provides an opportunity for health plans to identify older members with diabetes who are at highest risk of hypoglycemia and implement preventive interventions and more intensive management.
Learn More