Introduction & Objective: There is a paucity of data on the use of continuous glucose monitoring (CGM) in real-world inpatient settings for type 1 diabetes (T1D). Using remote monitoring, a large Southern California health system implemented CGM as standard of care (CGM as SOC) amid the COVID-19 pandemic. This analysis describes the characteristics and course of individuals with T1D who participated in CGM as SOC.
Methods: Patient characteristics were captured from the electronic health record. CGM data was extracted using Dexcom Clarity and processed using R.
Results: From 2020-2023, there were N=74 enrollments into CGM as SOC for 54 unique adults with T1D (Fig 1A). Comorbidity burden of enrolled patients was high, and mean admission HbA1c was 9.6%± 2.7. Participants were on CGM for an average of 4.6 ± 5.8 days. Average glucose levels, as assessed by CGM, were 224.9 ± 49.6 mg/dL. Average time in hyperglycemia > 250 mg/dL was 36%, in extreme hyperglycemia > 400 mg/dL was 5%, and in hypoglycemia < 70 mg/dL was 1.3%. Hypoglycemic events (15+ min <70 mg/dL) occurred in 34% of enrollments (Fig 1B). In Fig 1C, glucose readings demonstrate a reduction of extreme deviations after enrollment. CGM was acceptable by patients and RN staff.
Conclusion: This CGM as SOC protocol was feasible for inpatient T1D monitoring and management in a real-world hospital setting. Hypoglycemia and extreme hyperglycemia were infrequent.
S.R. Spierling Bagsic: None. S. Lohnes: Consultant; Dexcom, Inc. A.L. Fortmann: None. R. Belasco: None. H. Sandoval: None. A. Bastian: None. L. Talavera: None. D.J. Winkler: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.
Scripps Health and the David Winkler Endowment
