Glucose as the Fifth Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Hospital Setting
Addie L. Fortmann, Samantha R. Spierling Bagsic, Laura Talavera, Isabel Maria Garcia, Haley Sandoval, Amiry Hottinger, Athena Philis‐Tsimikas
Abstract
OBJECTIVE The current standard for hospital glucose management is point-of-care (POC) testing. We conducted a randomized controlled trial of real-time continuous glucose monitoring (RT-CGM) compared with POC in a non–intensive care unit (ICU) hospital setting. RESEARCH DESIGN AND METHODS A total of 110 adults with type 2 diabetes on a non-ICU floor received RT-CGM with Dexcom G6 versus usual care (UC). RT-CGM data were wirelessly transmitted from the bedside. Hospital telemetry monitored RT-CGM data and notified bedside nursing of glucose alerts and trends. Standardized protocols were used for interventions. RESULTS The RT-CGM group demonstrated significantly lower mean glucose (M∆ = −18.5 mg/dL) and percentage of time in hyperglycemia >250 mg/dL (−11.41%) and higher time in range 70–250 mg/dL (+11.26%) compared with UC (P values <0.05). Percentage of time in hypoglycemia was very low. CONCLUSIONS RT-CGM can be used successfully in community-based hospital non-ICU settings to improve glucose management. Continuously streaming glucose readings may truly be the fifth vital sign.