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 5 0.024), fewer clinically significant hypoglycemic events (<54 mg/dL) per patient (0.

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Respirator inspiratory resistance can affect performance times, especially when the experiment is optimized to elicit respiratory stress. Twelve subjects performed on a treadmill at constant speeds and grades chosen to result in performance times of 5-15 min. Six levels of inspiratory resistance were used, ranging from 0.78 to 7.64 cm H2O.sec/L. The results showed that performance times decrease linearly with resistance level, and no threshold resistance value is apparent. Inspiratory resistance also induces hypoventilation, with lower minute volumes and lower oxygen consumption values at higher resistances. These trends are also linear. From these results, there is no value for inspiratory resistance that can be given as a design goal. Other parameters such as weight and space may dictate filter resistance values, and these, in turn, will lead to determined performance degradations.

Advances in continuous glucose monitoring (CGM) have transformed ambulatory diabetes management. Until recently, inpatient use of CGM has remained investigational, with limited data on its accuracy in the hospital setting. RESEARCH DESIGN AND METHODSTo analyze the accuracy of Dexcom G6, we compared retrospective matched-pair CGM and capillary point-of-care (POC) glucose data from three inpatient CGM studies (two interventional and one observational) in general medicine and surgery patients with diabetes treated with insulin. Analysis of accuracy metrics included mean absolute relative difference (MARD), median absolute relative difference (ARD), and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of POC reference values for blood glucose >100 mg/dL or #100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses. RESULTSA total of 218 patients were included (96% with type 2 diabetes) with a mean age of 60.6 ± 12 years. The overall MARD (n 5 4,067 matched glucose pairs) was 12.8%, and median ARD was 10.1% (interquartile range 4.6, 17.6]. The proportions of readings meeting % 15/15, % 20/20, and % 30/30 criteria were 68.7, 81.7, and 93.8%, respectively. CEG analysis showed 98.7% of all values in zones A and B. MARD and median ARD were higher in the case of hypoglycemia (<70 mg/dL) and severe anemia (hemoglobin <7 g/dL). CONCLUSIONSOur results indicate that CGM technology is a reliable tool for hospital use and may help improve glucose monitoring in non-critically ill hospitalized patients with diabetes.Continuous glucose monitoring (CGM) technology in the outpatient setting has transformed glucose monitoring for diabetes self-management, providing more comprehensive glycemic control data than intermittent point-of-care (POC) blood glucose (BG) monitoring and hemoglobin A 1c . Ambulatory use of CGM continues to expand as devices improve in accuracy, accessibility, ease of use, and standardization of metrics for CGM data reporting (1).