Ana M Gómez1, Guillermo E Umpierrez2, Oscar M Muñoz3, Felipe Herrera1, Claudia Rubio4, Pablo Aschner5, Richard Buendia6. 1. Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia. 2. Department of Medicine, Emory University, Atlanta, GA, USA Division of Endocrinology, Metabolism and Lipids, Emory University, Atlanta, GA, USA. 3. Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia o.munoz@javeriana.edu.co. 4. Hospital Universitario San Ignacio, Bogotá, Colombia Clínica La Colina, Bogotá, Colombia. 5. Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia Endocrinology Unit, Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia. 6. Endocrinology Unit, Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Abstract
BACKGROUND: Continuous glucose monitoring (CGM) may improve the management of patients with type 2 diabetes hospitalized in the general ward by facilitating the detection of hyper- and hypoglycemic episodes. However, the lack of data on the accuracy and safety of CGM have limited its application. METHODS: A prospective pilot study was conducted including 38 patients hospitalized in the general ward with a known diagnosis of type 2 diabetes mellitus (DM) and hyperglycemic individuals without a history of DM with a blood sugar of 140-400 mg on admission treated with a basal bolus insulin regimen. Inpatient glycemic control and the incidence of hypoglycemic episodes were compared between detection by CGM of interstitial fluid for up to 6 days and point-of-care (POC) capillary blood glucose monitoring performed pre- and postprandially, before bedtime and at 3 am. RESULTS: No differences in average daily glucose levels were observed between CGM and POC (176.2 ± 33.9 vs 176.6 ± 33.7 mg/dl, P = .828). However, CGM detected a higher number of hypoglycemic episodes than POC (55 vs 12, P < .01). Glucose measurements were clinically valid, with 91.9% of patients falling within the Clarke error grid A and B zones. CONCLUSIONS: Our preliminary results indicate that the use of CGM in type 2 patients hospitalized in the general ward provides accurate estimation of blood sugar levels and is more effective than POC for the detection of hypoglycemic episodes and asymptomatic hypoglycemia.
BACKGROUND: Continuous glucose monitoring (CGM) may improve the management of patients with type 2 diabetes hospitalized in the general ward by facilitating the detection of hyper- and hypoglycemic episodes. However, the lack of data on the accuracy and safety of CGM have limited its application. METHODS: A prospective pilot study was conducted including 38 patients hospitalized in the general ward with a known diagnosis of type 2 diabetes mellitus (DM) and hyperglycemic individuals without a history of DM with a blood sugar of 140-400 mg on admission treated with a basal bolus insulin regimen. Inpatient glycemic control and the incidence of hypoglycemic episodes were compared between detection by CGM of interstitial fluid for up to 6 days and point-of-care (POC) capillary blood glucose monitoring performed pre- and postprandially, before bedtime and at 3 am. RESULTS: No differences in average daily glucose levels were observed between CGM and POC (176.2 ± 33.9 vs 176.6 ± 33.7 mg/dl, P = .828). However, CGM detected a higher number of hypoglycemic episodes than POC (55 vs 12, P < .01). Glucose measurements were clinically valid, with 91.9% of patientsfalling within the Clarke error grid A and B zones. CONCLUSIONS: Our preliminary results indicate that the use of CGM in type 2 patients hospitalized in the general ward provides accurate estimation of blood sugar levels and is more effective than POC for the detection of hypoglycemic episodes and asymptomatic hypoglycemia.
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