Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK

Background COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. Methods Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay. Results During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values <0.05). The average glucose was significantly associated with percentage of time in hypoglycaemia, percentage of time in range, and HbA1c (all p-values <0.05). Discussion We report the first pilot inpatient use of digital flash glucose monitors in an NHS hospital to support care of inpatients with diabetes and COVID-19. Overall, there are strong arguments for the inpatient use of these devices in the COVID-19 setting, and the findings of this pilot demonstrate feasibility of this digitally enabled approach and support wider use for inpatients with diabetes and COVID-19.

Download Full-text

979-P: Lower Glucose Thresholds for Hyperglycemia Alarm and Narrower Threshold Range for Hyper/Hypoglycemia Alarm on Continuous Glucose Monitoring Systems Correlate with Lower Average Glucose Levels and Longer Time-in-Range

Diabetes ◽

10.2337/db19-979-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 979-P

Author(s):

YU KUEI LIN ◽

MAN HUNG ◽

ANU SHARMA ◽

OWEN CHAN ◽

MICHAEL VARNER ◽

...

Keyword(s):

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Monitoring Systems ◽

Glucose Levels ◽

Lower Glucose ◽

Time In Range ◽

Average Glucose ◽

Threshold Range

Download Full-text

Cost Effectiveness Analysis of Flash Glucose Monitoring for Type 2 Diabetes Patients Receiving Insulin Treatment In The Uk

Value in Health ◽

10.1016/j.jval.2014.08.730 ◽

2014 ◽

Vol 17 (7) ◽

pp. A351 ◽

Cited By ~ 1

Author(s):

H. Li ◽

S.P. Bilir ◽

P. Donga ◽

A. Samiian ◽

J. Munakata

Keyword(s):

Type 2 Diabetes ◽

Cost Effectiveness ◽

Insulin Treatment ◽

Glucose Monitoring ◽

Cost Effectiveness Analysis ◽

Flash Glucose Monitoring ◽

Effectiveness Analysis ◽

The Uk ◽

Diabetes Patients

Download Full-text

Frequency of flash glucose monitoring readings, hemoglobin A1c and time in range: a real life study in adults with type 1 diabetes

Acta Diabetologica ◽

10.1007/s00592-020-01577-7 ◽

2020 ◽

Vol 57 (11) ◽

pp. 1395-1397 ◽

Cited By ~ 1

Author(s):

Andrea Laurenzi ◽

Amelia Caretto ◽

Mariluce Barrasso ◽

Andrea Mario Bolla ◽

Nicoletta Dozio ◽

...

Keyword(s):

Type 1 Diabetes ◽

Hemoglobin A1c ◽

Real Life ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

Life Study ◽

Time In Range ◽

Real Life Study

Download Full-text

Flash glucose monitoring reduces glycemic variability and hypoglycemia: real-world data from Spain

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-001052 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001052 ◽

Cited By ~ 4

Author(s):

Fernando Gomez-Peralta ◽

Timothy Dunn ◽

Katherine Landuyt ◽

Yongjin Xu ◽

Juan Francisco Merino-Torres

Keyword(s):

Real World ◽

Glucose Monitoring ◽

Glycemic Variability ◽

Real World Data ◽

Flash Glucose Monitoring ◽

Testing Frequency ◽

Scan Rate ◽

Time In Range ◽

Glycemic Markers ◽

Design And Methods

ObjectiveObservations in real-world settings support and extend findings demonstrated in randomized controlled trials that show flash glucose monitoring improves glycemic control. In this study, Spain-specific relationships between testing frequency and glycemic parameters were investigated under real-world settings.Research design and methodsDeidentified glucose and user scanning data were analyzed and readers were rank ordered into 20 equal sized groups by daily scan frequency. Glucose parameters were calculated for each group: estimated HbA1c, time below range (<70 and ≤54 mg/dL), within range (70–180 mg/dL), and above range (>180 mg/dL). Glycemic variability (GV) metrics were described and data obtained from sensors in Spain and worldwide were compared.ResultsSpanish users (n=22 949) collected 37.1 million glucose scans, 250 million automatically recorded glucose readings, and checked glucose values via a mean of 13 scans/day. Estimated HbA1c, time below 70 mg/dL, at or below 54 mg/dL, above 180 mg/dL, and GV metrics were significantly lower in the highest compared with lowest scan rate group (39.6 to 3.9 scans/day). Time-in-range was higher for the highest versus lowest scan rate group at 15.6 vs 11.5 hours/day, respectively. GV metrics correlated positively with time below 70 mg/dL, at or below 54 mg/dL, above 180 mg/dL, and negatively with time-in-range. The relationship between glucose metrics and scan rate was similar in Spain and worldwide. However, time in hypoglycemia in Spain was higher in the groups with lower scan rates.ConclusionsAs seen in clinical trials, flash glucose monitoring in real-world settings allows frequent glucose checks. High scan rates are associated with the favorable glycemic markers of increased time-in-range and reduced time in hyperglycemia and hypoglycemia, and GV. The same trends, with unique nuances, are observed in both Spanish and global data.

Download Full-text