Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

Rodolfo J. Galindo, Guillermo E. Umpierrez, Robert J. Rushakoff, Ananda Basu, Suzanne Lohnes, James H. Nichols, Elias K. Spanakis, Juan Espinoza, Nadine E. Palermo, Dessa Garnett Awadjie, Leigh Bak, Bruce Buckingham, Curtiss B. Cook, Guido Freckmann, Lutz Heinemann, Roman Hovorka, Nestoras Mathioudakis, Tonya Newman, David N. O’Neal, Michaela RickertDavid B. Sacks, Jane Jeffrie Seley, Amisha Wallia, Trisha Shang, Jennifer Y. Zhang, Julia Han, David C. Klonoff*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes.

Original languageEnglish (US)
Pages (from-to)1035-1064
Number of pages30
JournalJournal of Diabetes Science and Technology
Volume14
Issue number6
DOIs
StatePublished - 2020

Keywords

  • COVID-19
  • automated insulin dosing
  • continuous glucose monitor
  • guideline
  • hospital

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering

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