Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, GA, USA.
Diabetes Technology Society, Burlingame, CA, USA.
Endocrinol Metab (Seoul). 2021 Apr;36(2):240-255. doi: 10.3803/EnM.2021.201. Epub 2021 Mar 31.
Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.
连续血糖监测仪(CGM)在许多医院突然成为常规护理的一部分。2019 年冠状病毒病(COVID-19)大流行需要使用新技术和新流程来护理住院患者,包括糖尿病患者。使用 CGM 自动和远程补充或替代床边护士对血糖的辅助监测,可以减少:与糖尿病 COVID-19 患者接触的必要护理暴露量;获得血糖测量值所需的时间;以及在进行血糖测试时与患者互动所需的个人防护设备的数量。美国食品和药物管理局(FDA)现在行使执法自由裁量权,不反对在医院环境中使用某些工厂校准的 CGM,这既有利于患者护理,也有利于获得可用于未来监管提交的数据。CGM 可在医院中用于减少指尖毛细血管血糖检测的频率,减少高血糖发作,并减少低血糖发作。关于 CGM 在医院中的研究主要集中在其准确性上,直到最近才报告了结果数据。医院 CGM 计划需要医生、床边护士、糖尿病教育者和医院管理人员的合作,以适当选择和管理患者。为了使该计划取得成功,必须建立用于收集、审查、存储和响应 CGM 数据的流程。CGM 技术正在不断发展,我们预计 CGM 将越来越多地用于医院中患有糖尿病的患者。