Continuous Glucose Monitoring in General Wards for Prevention of Hypoglycemia: Results From the Glucose Telemetry System Pilot Study

Limited evidence is available about the use of continuous glucose monitoring (CGM) in general wards. In this pilot study we evaluated the use of the glucose telemetry system (GTS) using CGM technology and remote monitoring to prevent inpatient hypoglycemia in high-risk insulin-treated patients with type 2 diabetes (DM2).

A prospective, single-center, randomized pilot study was conducted to determine whether GTS can prevent inpatient hypoglycemia. Patients were randomized to standard of care with point-of-care glucose testing or to the intervention group with GTS. Both groups used CGM (blinded vs real time). Our primary goal was prevention of inpatient hypoglycemia.

A total of 13 subjects completed the study: 7 in the standard of care and 6 in the intervention group. The hypoglycemia event rate was 0.20 ± 0.23 episodes/day in standard of care vs 0.07 ± 0.11 episodes/day in the intervention group (P = .31). Six hypoglycemic events occurred in the standard of care vs two in the intervention group. Percentage of time spent <70 mg/dL was 2.44% ± 3.86% vs 0.30% ± 0.39% (P = .54) and time spent <54 mg/dL was 0.29% ± 0.47% vs 0% (P = .19) in the standard-of-care and intervention groups, respectively.

Utilizing GTS for DM2 insulin-treated patients in the general wards may be beneficial in reducing hypoglycemia. Based on the results of our pilot study we have initiated a large-scale randomized-controlled trial to further evaluate GTS in the general wards in patients with DM2 at high risk for inpatient hypoglycemia.