OBJECTIVE: Use of real-time continuous glucose monitoring
(RT-CGM) systems in the inpatient setting is considered investigational. The objective of this study was to
evaluate whether RT-CGM, using the glucose telemetry system (GTS), can prevent
hypoglycemia in the general wards.
<p>RESEARCH DESIGN AND METHODS: In a randomized
clinical trial, insulin-treated patients at high risk for hypoglycemia with
type 2 diabetes were recruited. Participants were randomized to RT-CGM/GTS or
point of care (POC) blood glucose testing. The primary outcome was difference in
inpatient hypoglycemia.</p>
<p>RESULTS: Seventy-two participants were included in this interim analysis,
36 in the RT-CGM/GTS group and 36 in the POC group. RT-CGM/GTS group experienced fewer
hypoglycemic events (<70 mg/dL) per patient (0.67 events per patient, 95% CI
0.34-1.30 versus 1.69 events per patient, 95% CI 1.11-2.58, <i>p</i>=0.024) and fewer clinically
significant hypoglycemic events (<54
mg/dL) per patient (0.08 events per patient, 95% CI 0.03-0.26 versus 0.75, 95%
CI 0.51-1.09, <i>p</i>=0.003). RT-CGM/GTS had lower percentage of time spent
below range <70 mg/dl (0.40%, 95% CI 0.18%-0.92% versus 1.88%, 95% CI
1.26%-2.81%, <i>p</i>=0.002) and <54 mg/dL
(0.05%, 95% CI 0.01%-0.43% versus 0.82%, 95% CI 0.47%-1.43%, <i>p</i>=0.017)
compared to POC group. No differences in nocturnal hypoglycemia, time in range 70-180 mg/dL, time above range >180-250 mg/dL and >250
mg/dL were found between the groups. RT-CGM/GTS
group had no prolonged hypoglycemia compared to 0.20 episodes
<54mg/dL and 0.40 episodes <70mg/dL per patient in the POC group. </p>
<p>CONCLUSIONS: RT-CGM/GTS
can decrease hypoglycemia among hospitalized high risk insulin treated patients
with type 2 diabetes.</p>
Reducing Inpatient Hypoglycemia in the General Wards Using Real-time Continuous Glucose Monitoring: The Glucose Telemetry System, a Randomized Clinical Trial
