People living with diabetes have both a higher risk of being hospitalized, and once in the hospital, are likely to stay there longer compared with people without diabetes. The reasons include serious medication errors, especially related to the prescription and use of insulin.

Continuous glucose monitoring while in the hospital

Many people with type 1 diabetes and some with type 2 diabetes are familiar with continuous glucose monitoring (CGM). A CGM works through a tiny sensor inserted under the skin, usually on the belly or arm. The sensor measures the interstitial glucose level – glucose in the fluid between cells. The sensor tests glucose every few minutes for up to 14 days. A wireless transmitter sends the information to a monitor which can be easily viewed. This enables people to track their glucose levels, change to their lifestyle, and adjust their diabetes medication.

Improving patient safety using technology

Modern CGM systems have two very attractive features. First, they are factory-calibrated, reducing the need for painful fingerstick testing. Second, the accuracy is close to that of traditional blood glucose monitors. Recently the U.S. Food and Drug Administration (FDA) gave permission (through its “Breakthrough Devices Program”) for CGM use in hospitals. The main use of CGM in the hospital so far has been to support use of intravenous insulin, including to prevent very high glucose levels caused by steroid treatments and also to reduce widely fluctuating glucose levels for very sick people fed through a vein. While more work is needed, it is likely that more and more people with diabetes who are hospitalized will need CGM.

CGM and other “biowearables” will be used more to provide early warning and to monitor seriously ill patients. This will improve the safety of hospitalized patients and is a very welcome step.


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