Cited by 154Diabetes Management and ResearchHyperglycemia and glycemic control in critically ill and hospitalized patientsDiabetes Treatment and Management

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Reducing Inpatient Hypoglycemia in the General Wards Using Real-time Continuous Glucose Monitoring: The Glucose Telemetry System, a Randomized Clinical Trial

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Singh, Lakshmi G., Satyarengga, Medha, Marcano, Isabel, Scott, William H., Pinault, Lillian F., Feng, Zhaoyong, Sorkin, John D., Umpierrez, Guillermo E., Spanakis, Elias K.·2020·Diabetes Care

DOI 10.2337/dc20-0840PMC PMC7576426

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Abstract

OBJECTIVE: Use of real-time continuous glucose monitoring (RT-CGM) systems in the inpatient setting is considered investigational. The objective of this study was to evaluate whether RT-CGM, using the glucose telemetry system (GTS), can prevent hypoglycemia in the general wards. RESEARCH DESIGN AND METHODS: In a randomized clinical trial, insulin-treated patients with type 2 diabetes at high risk for hypoglycemia were recruited. Participants were randomized to RT-CGM/GTS or point-of-care (POC) blood glucose testing. The primary outcome was difference in inpatient hypoglycemia. RESULTS: Seventy-two participants were included in this interim analysis, 36 in the RT-CGM/GTS group and 36 in the POC group. The RT-CGM/GTS group experienced fewer hypoglycemic events (<70 mg/dL) per patient (0.67 [95% CI 0.34–1.30] vs. 1.69 [1.11–2.58], P = 0.024), fewer clinically significant hypoglycemic events (<54 mg/dL) per patient (0.08 [0.03–0.26] vs. 0.75 [0.51–1.09], P = 0.003), and a lower percentage of time spent below range <70 mg/dL (0.40% [0.18–0.92%] vs. 1.88% [1.26–2.81%], P = 0.002) and <54 mg/dL (0.05% [0.01–0.43%] vs. 0.82% [0.47–1.43%], P = 0.017) compared with the POC group. No differences in nocturnal hypoglycemia, time in range 70–180 mg/dL, and time above range >180–250 mg/dL and >250 mg/dL were found between the groups. The RT-CGM/GTS group had no prolonged hypoglycemia compared with 0.20 episodes <54 mg/dL and 0.40 episodes <70 mg/dL per patient in the POC group. CONCLUSIONS: RT-CGM/GTS can decrease hypoglycemia among hospitalized high-risk insulin-treated patients with type 2 diabetes.

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“250mg/dLaswell as time in range (TIR) 70–180 mg/dL (23).”
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Authors: Singh, L. G., Satyarengga, M., Marcano, I., Scott, W. H., Pinault, L. F., Feng, Z., Sorkin, J. D., Umpierrez, G. E., & Spanakis, E. K.
Affiliations: Baltimore VA Medical Center (US)
Center for Diabetes and Endocrinology, University of Maryland Shore Regional Health, Easton, MD
University of Maryland, Baltimore (US)
Emory University (US)
Corresponding author: Spanakis, Elias K.
ORCID: Satyarengga, Medha
Pinault, Lillian F.
Sorkin, John D.
Umpierrez, Guillermo E.
Spanakis, Elias K.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2020-08-05
Volume: 43
Issue: 11
Pages: 2736-2743
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc20-0840
PMC: PMC7576426
OpenAlex: W3047317123
Cited by: 154
References: 35
Citations by year: 2026: 18 · 2025: 24 · 2024: 31 · 2023: 19 · 2022: 26 · 2021: 27 · 2020: 9
FWCI: 15.27
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.diabetesjournals.org/content/license (vor, 76 d)
Locations: Diabetes Care (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Veterans Affairs Clinical Sciences Research and Development Service (VA MERIT award (#1I01CX001825))
VA Medical Center GRECC
National Institute on Aging
National Institute of Diabetes and Digestive and Kidney Diseases (DK-072488)
National Institutes of Health (UL1-TR-002378, P30-DK-111024)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: real-time continuous glucose monitoring, type 2 diabetes, insulin-treated patients, nocturnal hypoglycemia, time in range, hospitalized patients, hypoglycemia prevention

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Reducing Inpatient Hypoglycemia in the General Wards Using Real-time Continuous Glucose Monitoring: The Glucose Telemetry System, a Randomized Clinical Trial

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