Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

Author:

Galindo Rodolfo J.1ORCID,Umpierrez Guillermo E.1,Rushakoff Robert J.2,Basu Ananda3,Lohnes Suzanne4,Nichols James H.5ORCID,Spanakis Elias K.67ORCID,Espinoza Juan8ORCID,Palermo Nadine E.9,Awadjie Dessa Garnett10,Bak Leigh11,Buckingham Bruce12,Cook Curtiss B.13,Freckmann Guido14ORCID,Heinemann Lutz15ORCID,Hovorka Roman16,Mathioudakis Nestoras17,Newman Tonya18,O’Neal David N.19ORCID,Rickert Michaela20,Sacks David B.21ORCID,Seley Jane Jeffrie22,Wallia Amisha23,Shang Trisha24ORCID,Zhang Jennifer Y.24ORCID,Han Julia24,Klonoff David C.25ORCID

Affiliation:

1. Emory University School of Medicine, Atlanta, GA, USA

2. University of California, San Francisco, CA, USA

3. University of Virginia School of Medicine, Charlottesville, VA, USA

4. University of California San Diego Medical Center, La Jolla, CA, USA

5. Vanderbilt University Medical Center, Nashville, TN, USA

6. University of Maryland School of Medicine, Baltimore, MD, USA

7. Division of Endocrinology, Baltimore Veterans Affairs Medical Center, MD, USA

8. Children’s Hospital Los Angeles, CA, USA

9. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

10. New York University Langone Health, NY, USA

11. Yale New Haven Hospital, CT, USA

12. Stanford University School of Medicine, Palo Alto, CA, USA

13. Mayo Clinic Arizona, Scottsdale, AZ, USA

14. Institute for Diabetes-Technology GmbH, Ulm, Germany

15. Science Consulting in Diabetes GmbH, Neuss, Germany

16. University of Cambridge, UK

17. Johns Hopkins University School of Medicine, Baltimore, MD, USA

18. Neal, Gerber and Eisenberg LLP, Chicago, IL, USA

19. University of Melbourne Department of Medicine, St. Vincent’s Hospital, Fitzroy, Victoria, Australia

20. Oregon Health and Sciences University, Portland, OR, USA

21. National Institutes of Health, Bethesda, MD, USA

22. Weill Cornell Medicine, New York, NY, USA

23. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

24. Diabetes Technology Society, Burlingame, CA, USA

25. Mills-Peninsula Medical Center, San Mateo, CA, USA

Abstract

This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes.

Funder

abbott diabetes care

dexcom

medtronic

Publisher

SAGE Publications

Subject

Biomedical Engineering,Bioengineering,Endocrinology, Diabetes and Metabolism,Internal Medicine

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