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  1. Article ; Online: Continuous Glucose Monitoring in the Hospital.

    Perez-Guzman, M Citlalli / Shang, Trisha / Zhang, Jennifer Y / Jornsay, Donna / Klonoff, David C

    Endocrinology and metabolism (Seoul, Korea)

    2021  Volume 36, Issue 2, Page(s) 240–255

    Abstract: Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals ... remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease ... of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease ...

    Abstract Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.
    MeSH term(s) Blood Glucose/metabolism ; Blood Glucose Self-Monitoring/methods ; Blood Glucose Self-Monitoring/trends ; COVID-19/epidemiology ; COVID-19/prevention & control ; Diabetes Mellitus/blood ; Diabetes Mellitus/epidemiology ; Hospitals/trends ; Humans ; Hypoglycemia/blood ; Hypoglycemia/epidemiology ; Hypoglycemia/prevention & control ; Monitoring, Ambulatory/methods ; Monitoring, Ambulatory/trends
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2021-03-31
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ZDB-ID 2802452-7
    ISSN 2093-5978 ; 2093-5978
    ISSN (online) 2093-5978
    ISSN 2093-5978
    DOI 10.3803/EnM.2021.201
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Real-Time Continuous Glucose Monitoring in the Hospital: A Real-World Experience.

    Spierling Bagsic, Samantha R / Fortmann, Addie L / Belasco, Rebekah / Bastian, Alessandra / Lohnes, Suzanne / Ritko, Anna / Sandoval, Haley / Chichmarenko, Mariya / Soriano, Emily C / Talavera, Laura / Philis-Tsimikas, Athena

    Journal of diabetes science and technology

    2023  Volume 17, Issue 3, Page(s) 656–666

    Abstract: ... among patients with diabetes. Bedside point-of-care (POC) glucose monitoring has remained the gold standard ... Diego, California, implemented CGM as the new "standard of care" (CGM as SOC) for glucose monitoring and ... for decades, while only providing momentary glimpses into a patient's glycemic control. Continuous glucose ...

    Abstract Background: Glycemic control in the hospital setting is imperative for improving outcomes among patients with diabetes. Bedside point-of-care (POC) glucose monitoring has remained the gold standard for decades, while only providing momentary glimpses into a patient's glycemic control. Continuous glucose monitoring (CGM) has been shown to improve glycemic control in the ambulatory setting. However, a paucity of inpatient experience and data remains a barrier to US Food and Drug Administration (FDA) approval and expanded/non-research use in the hospital setting.
    Method: Amid the COVID-19 pandemic, the FDA exercised its enforcement discretion to not object to the use of CGM systems for the treatment of patients in hospital settings to support COVID-19 health care-related efforts to reduce viral exposure of health care workers. Following this announcement, Scripps Health, a large not-for-profit health care system in San Diego, California, implemented CGM as the new "standard of care" (CGM as SOC) for glucose monitoring and management in the hospital.
    Results: The present report serves to (1) detail the implementation procedures for employing this new SOC; (2) describe the patients receiving CGM as SOC, their glycemic control, and hospital outcomes; and (3) share lessons learned over two years and nearly 900 hospital encounters involving CGM.
    Conclusions: Here, we conclude that CGM is feasible in the hospital setting by using a dedicated diabetes care team and the CGM technology with remote monitoring.
    MeSH term(s) Humans ; Blood Glucose ; Blood Glucose Self-Monitoring/methods ; COVID-19 ; Pandemics ; Diabetes Mellitus/therapy ; Hospitals ; Diabetes Mellitus, Type 1/drug therapy
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2023-04-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-2968
    ISSN (online) 1932-2968
    DOI 10.1177/19322968231165982
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Implementation of Continuous Glucose Monitoring in the Hospital

    Galindo, R.J. / Aleppo, G. / Spanakis, E.K.

    Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

    2020  

    Abstract: Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting ... for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic ... tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope ...

    Abstract Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.

    https://doi.org/10.1177/1932296820932903
    Keywords CGM ; continuous glucose monitoring ; COVID-19 ; diabetes mellitus ; hospitalized ; inpatient ; type 2 ; covid19
    Subject code 670
    Language English
    Publisher SAGE Publications Inc.
    Publishing country us
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Implementation of Continuous Glucose Monitoring in the Hospital

    Galindo, Rodolfo J. / Aleppo, Grazia / Klonoff, David C. / Spanakis, Elias K. / Agarwal, Shivani / Vellanki, Priya / Olson, Darin E. / Umpierrez, Guillermo E. / Davis, Georgia M. / Pasquel, Francisco J.

    Journal of Diabetes Science and Technology

    Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

    2020  Volume 14, Issue 4, Page(s) 822–832

    Abstract: Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting ... for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic ... tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope ...

    Abstract Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.
    Keywords Internal Medicine ; Bioengineering ; Endocrinology, Diabetes and Metabolism ; Biomedical Engineering ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ISSN 1932-2968
    DOI 10.1177/1932296820932903
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Continuous glucose monitoring in the hospital: an update in the era of COVID-19.

    Gothong, Chikara / Singh, Lakshmi G / Satyarengga, Medha / Spanakis, Elias K

    Current opinion in endocrinology, diabetes, and obesity

    2021  Volume 29, Issue 1, Page(s) 1–9

    Abstract: Purpose of review: Continuous glucose monitoring (CGM) systems are Food and Drug Administration ... This review summarizes the most recent and relevant literature on the use of continuous glucose monitoring ... appear to be safe and accurate systems for glucose monitoring in the hospital setting. Real-time CGM ...

    Abstract Purpose of review: Continuous glucose monitoring (CGM) systems are Food and Drug Administration approved devices for the ambulatory setting; however, they remain investigational systems for inpatient use. This review summarizes the most recent and relevant literature on the use of continuous glucose monitoring in the hospital setting.
    Recent findings: CGM provides real-time glucose data that enable healthcare professionals to make proactive and timelier clinical decisions with regards to diabetes management. CGM devices appear to be safe and accurate systems for glucose monitoring in the hospital setting. Real-time CGM systems and glucose telemetry can decrease hypoglycemia and reduce hyperglycemia in hospitalized patients with diabetes. Remote glucose monitoring decreases the need of frequent Point-of-care checks and personal protective equipment use while also mitigating staff exposure risk which is timely in the advent of the COVID-19 pandemic. Although most nursing staff have limited exposure and training on CGM technology, early studies show that CGM use in the hospital is well received by nurses.
    Summary: Given the evidence in the current literature regarding CGM use in the hospital, CGM devices may be incorporated in the inpatient setting.
    MeSH term(s) Blood Glucose ; Blood Glucose Self-Monitoring ; COVID-19 ; Diabetes Mellitus, Type 1 ; Hospitals ; Humans ; Pandemics ; SARS-CoV-2
    Chemical Substances Blood Glucose
    Language English
    Publishing date 2021-11-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2272017-0
    ISSN 1752-2978 ; 1752-296X
    ISSN (online) 1752-2978
    ISSN 1752-296X
    DOI 10.1097/MED.0000000000000693
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  6. Article ; Online: Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic.

    Galindo, Rodolfo J / Aleppo, Grazia / Klonoff, David C / Spanakis, Elias K / Agarwal, Shivani / Vellanki, Priya / Olson, Darin E / Umpierrez, Guillermo E / Davis, Georgia M / Pasquel, Francisco J

    Journal of diabetes science and technology

    2020  Volume 14, Issue 4, Page(s) 822–832

    Abstract: Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting ... for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic ... tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope ...

    Abstract Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.
    MeSH term(s) Betacoronavirus ; Blood Glucose/analysis ; Blood Glucose Self-Monitoring/methods ; COVID-19 ; Calibration ; Communicable Disease Control ; Coronavirus Infections/epidemiology ; Diabetes Complications/therapy ; Diabetes Mellitus/blood ; Diabetes Mellitus/therapy ; Electronic Health Records ; Hospitalization ; Hospitals ; Humans ; Hyperglycemia/blood ; Hyperglycemia/complications ; Hyperglycemia/diagnosis ; Inpatients ; Insulin Infusion Systems ; Monitoring, Ambulatory ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; United States ; United States Food and Drug Administration
    Chemical Substances Blood Glucose
    Keywords covid19
    Language English
    Publishing date 2020-06-14
    Publishing country United States
    Document type Journal Article
    ISSN 1932-2968
    ISSN (online) 1932-2968
    DOI 10.1177/1932296820932903
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  7. Article: Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

    Galindo, Rodolfo J / Aleppo, Grazia / Klonoff, David C / Spanakis, Elias K / Agarwal, Shivani / Vellanki, Priya / Olson, Darin E / Umpierrez, Guillermo E / Davis, Georgia M / Pasquel, Francisco J

    J Diabetes Sci Technol

    Abstract: Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting ... for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic ... tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope ...

    Abstract Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #598655
    Database COVID19

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  8. Article ; Online: Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital.

    Umpierrez, Guillermo E / Klonoff, David C

    Diabetes care

    2018  Volume 41, Issue 8, Page(s) 1579–1589

    Abstract: The use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM ... monitoring and conventional insulin treatment or with a favorable cost-benefit ratio. ... As the popularity of these devices increases, it becomes very likely that hospital health care providers will face ...

    Abstract The use of continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems has gained wide acceptance in diabetes care. These devices have been demonstrated to be clinically valuable, improving glycemic control and reducing risks of hypoglycemia in ambulatory patients with type 1 diabetes and type 2 diabetes. Approximately 30-40% of patients with type 1 diabetes and an increasing number of insulin-requiring patients with type 2 diabetes are using pump and sensor technology. As the popularity of these devices increases, it becomes very likely that hospital health care providers will face the need to manage the inpatient care of patients under insulin pump therapy and CGM. The American Diabetes Association advocates allowing patients who are physically and mentally able to continue to use their pumps when hospitalized. Health care institutions must have clear policies and procedures to allow the patient to continue to receive CSII treatment to maximize safety and to comply with existing regulations related to self-management of medication. Randomized controlled trials are needed to determine whether CSII therapy and CGM systems in the hospital are associated with improved clinical outcomes compared with intermittent monitoring and conventional insulin treatment or with a favorable cost-benefit ratio.
    MeSH term(s) Blood Glucose/drug effects ; Blood Glucose/metabolism ; Blood Glucose Self-Monitoring/economics ; Blood Glucose Self-Monitoring/instrumentation ; Blood Glucose Self-Monitoring/methods ; Cost-Benefit Analysis ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/economics ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/economics ; Diabetes Mellitus, Type 2/epidemiology ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Humans ; Hypoglycemia/chemically induced ; Insulin/administration & dosage ; Insulin/adverse effects ; Insulin/economics ; Insulin Infusion Systems/economics ; Risk Reduction Behavior
    Chemical Substances Blood Glucose ; Insulin
    Language English
    Publishing date 2018-06-23
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dci18-0002
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  9. Article ; Online: Response to Comment on Umpierrez and Klonoff. Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital. Diabetes Care 2018;41:1579-1589.

    Umpierrez, Guillermo E / Klonoff, David C

    Diabetes care

    2019  Volume 42, Issue 4, Page(s) e66–e67

    MeSH term(s) Blood Glucose ; Blood Glucose Self-Monitoring ; Diabetes Mellitus, Type 1 ; Humans ; Insulin Infusion Systems ; Insulins
    Chemical Substances Blood Glucose ; Insulins
    Language English
    Publishing date 2019-04-15
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dci18-0066
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  10. Article ; Online: Response to Comment on Umpierrez and Klonoff. Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital. Diabetes Care 2018;41:1579-1589.

    Umpierrez, Guillermo E / Klonoff, David C

    Diabetes care

    2019  Volume 42, Issue 1, Page(s) e15

    MeSH term(s) Blood Glucose ; Blood Glucose Self-Monitoring ; Diabetes Mellitus, Type 1 ; Humans ; Insulin Infusion Systems ; Insulins
    Chemical Substances Blood Glucose ; Insulins
    Language English
    Publishing date 2019-02-27
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dci18-0043
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