Glucose as the 5th Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a non-ICU Hospital Setting

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posted on 2020-08-28, 15:38 authored by Addie L. Fortmann, Samantha R Spierling Bagsic, Laura Talavera, Isabel Maria Garcia, Haley Sandoval, Amiry Hottinger, Athena Philis-Tsimikas

OBJECTIVE: The current standard for hospital glucose management is point-of-care (POC) testing. We conducted a randomized controlled trial comparing real-time CGM (RT-CGM) to POC in a non-ICU hospital setting.

RESEARCH DESIGN AND METHODS: N=110 adults with type 2 diabetes (T2D) on a non-ICU floor received RT-CGM with Dexcom G6 vs usual care (UC). RT-CGM data were wirelessly transmitted from the bedside. Hospital telemetry monitored RT-CGM data and notified bedside nursing of glucose alerts and trends. Standardized protocols were used for interventions.

RESULTS: The RT-CGM group demonstrated significantly lower mean glucose (M∆= -18.5 mg/dL) and percentage of time in hyperglycemia >250 mg/dL (-11.41%), and higher median TIR 70-250 mg/dL (+11.26%) compared with UC (ps<0.05). Percentage of time in hypoglycemia was very low.

CONCLUSION: RT-CGM can be used successfully in community-based hospital non-ICU settings to improve glucose management; continuously streaming glucose readings may truly be the 5^th vital sign.