1246-P: Reducing Hypoglycemia in the Noncritical Care Setting Using CGM Devices: The Glucose Telemetry System

Objective: In a pilot study we have previously demonstrated successful transmission of glucometric values from continuous glucose monitoring (CGM) devices to a monitoring system at the nursing station (Glucose Telemetry System-GTS). In an ongoing study, we are evaluating whether use of GTS can reduce inpatient hypoglycemia compared to point of care (POC) capillary glucose testing, without increasing hyperglycemia.

Design: Twenty-four patients with DM2 at high risk for inpatient hypoglycemia were randomized to GTS (N=12 intervention group) or POC (N=12 standard of care). Nursing staff were asked to proceed with hypoglycemia preventative actions for GTS low glucose alarms set at <85 mg/dL. Subjects randomized to standard of care used “blinded” CGM. Mean percent time spent in hypoglycemia, hyperglycemia, and hypoglycemia event rates were evaluated.

Results: Twenty-one subjects were included in the analysis, 2 subjects withdrew due to minor bleeding at CGM insertion site and 1 subject had insufficient CGM data due to sensor failure. 30 GTS hypoglycemia alarms occurred in 7 different subjects. Overall percent time spent in hypoglycemia (≤70 mg/dL) was 0.18%±0.21 versus 1.64%±1.59 (p=0.056), and clinically significant hypoglycemia (<54mg/dL) was 0.01%±0.01 versus 0.48%±1.07 (p=0.135), between intervention and control groups, respectively. Rate of hypoglycemic episodes per day/per patient was 0.12±0.17 vs. 0.27±0.33 (p=0.19) for GTS and POC, respectively. Percent time spent in normoglycemia (70-179 mg/dL) was 52.04%±23.65 versus 52.92%±27.37 (p=0.94), while percent time in hyperglycemia (≥180 mg/dL) was 47.80%±23.65 versus 45.43%±28.05 (p=0.84), respectively.

Conclusion: In this preliminary analysis, subjects monitored by GTS had a non-statistically significant decrease in inpatient hypoglycemia compared to standard of care.