Glucose as the Fifth Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Hospital Setting

Author:

Fortmann Addie L.1,Spierling Bagsic Samantha R.1,Talavera Laura1,Garcia Isabel Maria1,Sandoval Haley1,Hottinger Amiry1,Philis-Tsimikas Athena1ORCID

Affiliation:

1. Scripps Whittier Diabetes Institute, San Diego, CA

Abstract

OBJECTIVE The current standard for hospital glucose management is point-of-care (POC) testing. We conducted a randomized controlled trial of real-time continuous glucose monitoring (RT-CGM) compared with POC in a non–intensive care unit (ICU) hospital setting. RESEARCH DESIGN AND METHODS A total of 110 adults with type 2 diabetes on a non-ICU floor received RT-CGM with Dexcom G6 versus 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 time in range 70–250 mg/dL (+11.26%) compared with UC (P values <0.05). Percentage of time in hypoglycemia was very low. CONCLUSIONS 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 fifth vital sign.

Funder

National Center for Advancing Translational Sciences

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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