Accuracy and Precision of Continuous Glucose Monitoring in Hospitalized Patients Undergoing Radiology Procedures

Migdal, Alexandra; Spanakis, Elias K.; Galindo, Rodolfo J.; Davis, Georgia; Singh, Lakshmi G.; Satyarengga, Medha; Scott, William H.; Fayfman, Maya; Pasquel, Francisco J.; Albury, Bonnie; Urrutia, Maria A.; Coronado, K. Walkiria Zamudio; Cardona, Saumeth; Peng, Limin; Umpiérrez, Guillermo E.

doi:10.1177/1932296820930038

Cited by 30 publications

(16 citation statements)

References 5 publications

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“…18,116 Glucose monitoring devices should also be removed for certain procedures-with each company having their own list-such as MRI and diathermy. 117 Results from small clinical trials in patients with type 2 diabetes have suggested that real-time continuous glucose monitoring can be used successfully to improve glycaemic control in the hospital setting. 118,119 Reports during the COVID-19 pandemic have described the potential promise of using real-time continuous glucose monitoring in realworld hospital settings for remote inpatient diabetes management in non-ICU [120][121][122] and ICU patients.…”

Section: Point-of-care Testing and Continuous Glucose Monitoringmentioning

confidence: 99%

Management of diabetes and hyperglycaemia in the hospital

Pasquel

Lansang

Dhatariya

et al. 2021

The Lancet Diabetes & Endocrinology

183

132

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Hyperglycaemia in people with and without diabetes admitted to the hospital is associated with a substantial increase in morbidity, mortality, and health-care costs. Professional societies have recommended insulin therapy as the cornerstone of inpatient pharmacological management. Intravenous insulin therapy is the treatment of choice in the critical care setting. In non-intensive care settings, several insulin protocols have been proposed to manage patients with hyperglycaemia; however, meta-analyses comparing different treatment regimens have not clearly endorsed the benefits of any particular strategy. Clinical guidelines recommend stopping oral antidiabetes drugs during hospitalisation; however, in some countries continuation of oral antidiabetes drugs is commonplace in some patients with type 2 diabetes admitted to hospital, and findings from clinical trials have suggested that non-insulin drugs, alone or in combination with basal insulin, can be used to achieve appropriate glycaemic control in selected populations. Advances in diabetes technology are revolutionising day-to-day diabetes care and work is ongoing to implement these technologies (ie, continuous glucose monitoring, automated insulin delivery) for inpatient care. Additionally, transformations in care have occurred during the COVID-19 pandemic, including the use of remote inpatient diabetes management-research is needed to assess the effects of such adaptations.

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Section: Point-of-care Testing and Continuous Glucose Monitoringmentioning

confidence: 99%

Management of diabetes and hyperglycaemia in the hospital

Pasquel

Lansang

Dhatariya

et al. 2021

The Lancet Diabetes & Endocrinology

183

132

View full text Add to dashboard Cite

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“…Subjects undergoing MRI were excluded, given concerns about the potential impact of magnetic fields on CGM function and safety. 25 Recently, Thomas et al exposed G6 sensor/ transmitter pairs to X-rays to simulate a radiotherapeutic procedure and to radiofrequency and magnetic fields to simulate diagnostic MRI. 26 Consistent with the clinical observations, 25 the devices appear unlikely to be affected by X-irradiation used in imaging studies, except during MRI.…”

Section: When Should We Be Concerned About Biological Imaging or Otmentioning

confidence: 99%

“…25 Recently, Thomas et al exposed G6 sensor/ transmitter pairs to X-rays to simulate a radiotherapeutic procedure and to radiofrequency and magnetic fields to simulate diagnostic MRI. 26 Consistent with the clinical observations, 25 the devices appear unlikely to be affected by X-irradiation used in imaging studies, except during MRI. 26 Simulated MRI conditions, however, created displacement force, minimal heating, and current in sensor/transmitter pairs.…”

Section: When Should We Be Concerned About Biological Imaging or Otmentioning

confidence: 99%

Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

Galindo

Aleppo

Klonoff

et al. 2020

J Diabetes Sci Technol

Self Cite

112

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Continuous glucose monitoring (CGM) has become a widely used tool in the ambulatory setting for monitoring glucose levels, as well as detecting uncontrolled hyperglycemia, hypoglycemia, and glycemic variability. The accuracy of some CGM systems has recently improved to the point of manufacture with factory calibration and Food and Drug Administration clearance for nonadjunctive use to dose insulin. In this commentary, we analyze the answers to six questions about what is needed to bring CGM into the hospital as a reliable, safe, and effective tool. The evidence to date indicates that CGM offers promise as an effective tool for monitoring hospitalized patients. During the current coronavirus disease 2019 crisis, we hope to provide guidance to healthcare professionals, who are seeking to reduce exposure to SARS-Cov-2, as well as preserve invaluable personal protective equipment. In this commentary, we address who, what, where, when, why, and how CGM can be adopted for inpatient use.

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“…Performance may vary by glucose levels with higher values leading to more bias and less precision. Areas affecting accuracy and opportunities for improvement include, Preanalytical: such as pressure on sensor site, 130 X Rays, 131 lipohypertrophy, 132 Analytical: Interfering substances, 133,134 end-stage renal disease/dialysis, 135 and Postanalytical: hardware (parakeet, nightrider), software (Nightscout, Looping, tomato), and data analysis (human error). 136,137 Accuracy may even be more important for patients at high risk of hypoglycemia such as those with hypoglycemic unawareness.…”

Section: Consensusmentioning

confidence: 99%

Diabetes Technology Meeting 2020

Shang

Zhang

Bequette

et al. 2021

J Diabetes Sci Technol

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Diabetes Technology Society hosted its annual Diabetes Technology Meeting on November 12 to November 14, 2020. This meeting brought together speakers to cover various perspectives about the field of diabetes technology. The meeting topics included artificial intelligence, digital health, telemedicine, glucose monitoring, regulatory trends, metrics for expressing glycemia, pharmaceuticals, automated insulin delivery systems, novel insulins, metrics for diabetes monitoring, and discriminatory aspects of diabetes technology. A live demonstration was presented.

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Accuracy and Precision of Continuous Glucose Monitoring in Hospitalized Patients Undergoing Radiology Procedures

Cited by 30 publications

References 5 publications

Management of diabetes and hyperglycaemia in the hospital

Management of diabetes and hyperglycaemia in the hospital

Implementation of Continuous Glucose Monitoring in the Hospital: Emergent Considerations for Remote Glucose Monitoring During the COVID-19 Pandemic

Diabetes Technology Meeting 2020

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