Continuous Glucose Monitoring Versus Capillary Point-of-Care Testing for Inpatient Glycemic Control in Type 2 Diabetes Patients Hospitalized in the General Ward and Treated With a Basal Bolus Insulin Regimen.
BACKGROUND
Continuous glucose monitoring (CGM) may improve the management of patients with type 2 diabetes hospitalized in the general ward by facilitating the detection of hyper- and hypoglycemic episodes. However, the lack of data on the accuracy and safety of CGM have limited its application.


METHODS
A prospective pilot study was conducted including 38 patients hospitalized in the general ward with a known diagnosis of type 2 diabetes mellitus (DM) and hyperglycemic individuals without a history of DM with a blood sugar of 140-400 mg on admission treated with a basal bolus insulin regimen. Inpatient glycemic control and the incidence of hypoglycemic episodes were compared between detection by CGM of interstitial fluid for up to 6 days and point-of-care (POC) capillary blood glucose monitoring performed pre- and postprandially, before bedtime and at 3 am.


RESULTS
No differences in average daily glucose levels were observed between CGM and POC (176.2 ± 33.9 vs 176.6 ± 33.7 mg/dl, P = .828). However, CGM detected a higher number of hypoglycemic episodes than POC (55 vs 12, P < .01). Glucose measurements were clinically valid, with 91.9% of patients falling within the Clarke error grid A and B zones.


CONCLUSIONS
Our preliminary results indicate that the use of CGM in type 2 patients hospitalized in the general ward provides accurate estimation of blood sugar levels and is more effective than POC for the detection of hypoglycemic episodes and asymptomatic hypoglycemia.
Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia.
Ana M
AM
Gómez
Department of Medicine, Emory University, Atlanta, GA, USA Division of Endocrinology, Metabolism and Lipids, Emory University, Atlanta, GA, USA.
Guillermo E
GE
Umpierrez
Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia o.munoz@javeriana.edu.co.
Oscar M
OM
Muñoz
Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia.
Felipe
F
Herrera
Hospital Universitario San Ignacio, Bogotá, Colombia Clínica La Colina, Bogotá, Colombia.
Claudia
C
Rubio
Pontificia Universidad Javeriana, Bogotá, Colombia Hospital Universitario San Ignacio, Bogotá, Colombia Endocrinology Unit, Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Pablo
P
Aschner
Endocrinology Unit, Department of Internal Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Richard
R
Buendia
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010865:Pilot Projects; D000067716:Point-of-Care Testing
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
continuous glucose monitoring; hyperglycemia; hypoglycemia; point-of-care testing