Continuous Glucose Monitoring vs. Capillary Blood Glucose in Hospitalized Type 2 Diabetes Patients

• Published in: Curēus (Palo Alto, CA) CA), 2023-08, Vol.15 (8), p.e43832-e43832
• Main Authors: Veríssimo, David, Vinhais, Joana, Ivo, Catarina, Martins, Ana Cláudia, Nunes e Silva, João, Passos, Dolores, Lopes, Luís, Jácome de Castro, João, Marcelino, Mafalda
• Format: Article
• Language: English
• Subjects: Cohort analysis; Coronaviruses; COVID-19; Diabetes; Endocrinology/Diabetes/Metabolism; Glucose monitoring; Healthcare Technology; Hematology; Hemoglobin; Hospitalization; Hospitals; Hyperglycemia; Hypoglycemia; Independent sample; Insulin; Laboratories; Length of stay; Mann-Whitney U test; Metabolism; Mortality; Patients
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.43832

Introduction: The emergence of continuous glucose monitoring devices revolutionized the monitoring of diabetes, allowing real-time measurement of interstitial glucose levels. These devices are especially important for people with diabetes treated with insulin therapy and have been extensively studied in outpatient settings. In hospitalized patients, studies using continuous glucose monitoring have focused mainly on evaluating its accuracy and feasibility, but the results were unclear on whether continuous glucose monitoring was superior to capillary blood glucose in improving glycemic control and further research is needed to support the use of these devices in hospitalized patients with diabetes.Objective: The primary endpoint of this study was to assess the increase in time-in-range (glycemic readings between 100-180 mg/dL) in hospitalized patients with continuous glucose monitoring, compared to capillary blood glucose. The secondary endpoints included the assessment of reductions in hypoglycemia incidence, mean glucose levels, and glucose coefficient of variation. Additionally, we assessed the intervention's impact on reducing the length of hospital stay, mortality rates, and incidence of inpatient infections.Research design and methods: This was a retrospective, cohort study of 60 hospitalized patients with type 2 diabetes, divided into two groups of 30 individuals each: an intervention group monitored through continuous glucose monitoring and a control group using capillary blood glucose.Results: Both groups were comparable in terms of demographic and clinical characteristics. Continuous glucose monitoring users had a higher number of readings per day (six vs. four, p < 0.001), in-range readings (53.5% vs. 35%, p = 0.027), fewer above-range readings (25.5% vs. 56.5%, p = 0.003), particularly above 250 mg/dL (5% vs. 27.5%, p = 0.001), with no difference in the percentage of hypoglycemia occurence (1% vs. 0%, p = 0.107). Lower mean glucose (161.9 mg/dL vs. 206.5 mg/dL, p < 0.001) was also observed in this group. No difference was observed in mortality, length of stay, or in infection rate (p = 1.000, p = 0.455, and p = 0.606, respectively).Conclusions: This retrospective study supports the use of continuous glucose monitoring in optimizing glycemic control in hospitalized patients with type 2 diabetes on intensive insulin therapy. These findings suggest that continuous glucose monitoring can improve time-in-range and prevent hyperglycemia.