Glucose Monitoring Could Help Diabetics In Hospital: Scripps

SAN DIEGO, CA —According to research published Thursday by the Scripps Whittier Diabetes Institute, hospitalized patients with Type 2 diabetes who wore a wireless continuous glucose-monitoring device during admission saw significantly better control of their blood-sugar levels than similar patients who didn't wear the device.

The report, which appeared Thursday in the online version of the medical journal Diabetes Care, highlights results from the first large-scale, randomized and controlled clinical trial showing that the same types of continuous glucose-monitoring — CGM — technologies which have been available for home use for nearly 20 years can benefit some hospitalized patients in similar ways.

"Tracking vital signs is routine in many hospitalized patients," said Dr. Athena Philis-Tsimikas, vice president of Scripps Whittier and senior author of the report. "This study demonstrates that blood sugar should be considered the fifth vital sign for hospitalized diabetes patients -- joining temperature, pulse, respiration and blood pressure -- as a potentially crucial metric for delivering the highest quality care."

According to Scripps, blood-sugar levels in hospitalized patients with diabetes are often poorly managed when relying on the more traditional method of periodic finger sticks. Other conditions, such as stress, unpredictable timing of tests and procedures, new medications and the medical staff's focus on the patient's primary reason for hospitalization, can make glucose management even more difficult.

When blood sugar is too high for too long a period, it can cause serious problems such as heart disease or heart attack, stroke and damage to the kidneys, nerves and eyes.

In March, the U.S. Food and Drug Administration issued emergency authorization for the use of the glucose-monitoring devices in hospitals as a way to reduce the number of times nurses go into the rooms of COVID-19 patients, which in turn, could conserve more of the personal protective equipment needed to prevent the spread of the infection.

In May, Scripps began a glucose-monitoring program at Scripps Mercy Hospital San Diego.

"The current pandemic environment has greatly accelerated the need to find safe and effective ways to monitor the blood sugar of hospitalized patients without interfering with the necessary and often intensive interventions to treat COVID-19," said Addie Fortmann, director of the diabetes service line at Scripps and lead author of the paper. "Our study clearly demonstrates the value of CGM in community hospitals, and it offers a model for other health systems that are looking to use this technology in similar ways."

Researchers recruited 110 adult patients with Type 2 diabetes who were admitted to a medical/surgical floor at Scripps Mercy San Diego over a four-year period. The patients were randomized to be fitted with a CGM device or to receive the current standard for hospital glucose management — three pin-prick blood-sugar tests conducted every 24 hours.

According to the study, one barrier to the adoption of the devices more broadly in hospitals could be their cost.

For the clinical trial, researchers relied on a support team in the hospital to help manage the technology system, an expenditure not required when delivering the current standard care. Over time, the financial burden of such a team could be offset at least in part by the falling cost of continuous glucose-monitoring technology, the report noted.

— City News Service