Continuous Glucose Monitoring Improves Diabetes in Hospitalized Patients

Hospitalized patients with Type 2 diabetes who wore a wireless continuous glucose monitoring (CGM) device during their admission saw significantly better control of their blood sugar levels compared with similar patients who didn’t wear the device, according to newly published research from the Scripps Whittier Diabetes Institute.

The report, which appeared today in the online version of the medical journal Diabetes Care, highlights results from the first large-scale, randomized and controlled clinical trial showing that the same types of CGM technologies which have been available for home use for nearly 20 years can benefit some hospitalized patients in similar ways.

“Tracking vital signs is routine in many hospitalized patients,” said Athena Philis-Tsimikas, MD, corporate vice president of Scripps Whittier and the senior author of the report. “This study demonstrates that blood sugar should be considered the fifth vital sign for hospitalized diabetes patients, joining temperature, pulse, respiration and blood pressure, as a potentially crucial metric for delivering the highest quality care.”

The findings are significant because blood sugar levels in hospitalized patients with diabetes are often poorly managed when relying on the more traditional method of periodic finger sticks. Other conditions, such as stress, unpredictable timing of tests and procedures, new medications, and the medical staff’s focus on the patient’s primary reason for hospitalization, can make glucose management even more difficult.

It is essential to properly and continuously manage blood sugar levels in people with diabetes to ensure their long-term health. When blood sugar is too high (a common effect of diabetes known as hyperglycemia) for too long of a period, it can cause serious problems such as heart disease or heart attack, stroke, and damage to the kidneys, nerves and eyes.

The clinical trial results also speak to the ongoing coronavirus pandemic.

In March, the U.S. Food and Drug Administration (FDA) issued emergency authorization for the use of CGM devices in hospitals as a way to reduce the number of times nurses go into the rooms of COVID-19 patient, which in turn would conserve more of the personal protective equipment needed to prevent the spread of the infection.

Scripps in May became one of the first health systems to take advantage of the FDA’s decision by launching a CGM program at its Scripps Mercy Hospital San Diego. The move was made possible because of the hospital’s use of the technology as part of an earlier clinical trial.

“The current pandemic environment has greatly accelerated the need to find safe and effective ways to monitor the blood sugar of hospitalized patients without interfering with the necessary and often intensive interventions to treat COVID-19,” said Addie Fortmann, PhD, director of the diabetes service line at Scripps and the lead author of the paper. “Our study clearly demonstrates the value of CGM in community hospitals, and it offers a model for other health systems that are looking to use this technology in similar ways.”