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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 28.08.2020 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 5th vital sign.

Funding

Funding to support the research has been received from the Confidence Foundation, Diabetes Research Connection and NCATS 1UL1 TR002550-01, and DexCom for providing the G6 devices.

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