TY - JOUR
T1 - Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline
AU - Galindo, Rodolfo J.
AU - Umpierrez, Guillermo E.
AU - Rushakoff, Robert J.
AU - Basu, Ananda
AU - Lohnes, Suzanne
AU - Nichols, James H.
AU - Spanakis, Elias K.
AU - Espinoza, Juan
AU - Palermo, Nadine E.
AU - Awadjie, Dessa Garnett
AU - Bak, Leigh
AU - Buckingham, Bruce
AU - Cook, Curtiss B.
AU - Freckmann, Guido
AU - Heinemann, Lutz
AU - Hovorka, Roman
AU - Mathioudakis, Nestoras
AU - Newman, Tonya
AU - O’Neal, David N.
AU - Rickert, Michaela
AU - Sacks, David B.
AU - Seley, Jane Jeffrie
AU - Wallia, Amisha
AU - Shang, Trisha
AU - Zhang, Jennifer Y.
AU - Han, Julia
AU - Klonoff, David C.
N1 - Funding Information:
The authors thank the following meeting attendees for their contributions to the ideas summarized in this report: Leslie Landree and Courtney Lias (FDA). We would also like to acknowledge attendees Irina Nayberg (Mills-Peninsula Medical Center), Robby Booth (Glytec), Daniel Chernavsky (Dexcom), Jeff Draper (Abbott Diabetes Care), Corinne Fantz (Roche Diagnostics), Andrew S. Rhinehart (Medtronic), Robert A. Vigersky (Medtronic), Nauni Virdi (Abbott Diabetes Care), and Tomas C. Walker (Dexcom). The College of American Pathologists was represented by David B. Sacks, Endocrine Society was represented by Amisha Wallia, and the Association of Diabetes Care and Education Specialists was represented by Dessa Garnett Awadjie. We thank Jeffrey Joseph for providing background information. Finally, we thank Annamarie Sucher for her expert editorial assistance. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by grants from Abbott Diabetes Care, Dexcom, and Medtronic.
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RJG is supported in part by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institute of Health under Award Number 1K23DK123384-01 and P30DK11102. RJG received research support (to Emory University) for investigator-initiated studies from Novo Nordisk and Dexcom, and consulting fees from Abbott Diabetes Care, Eli Lilly, Sanofi, Novo Nordisk, and Valeritas. GEU is partly supported by research grants from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378 from the Clinical and Translational Science Award program and a National Institutes of Health (NIH) grant U30, P30DK11102, and has received research grant support to Emory University for investigator-initiated studies from Sanofi, Novo Nordisk, and Dexcom. AB received grant support through NIDDK 085516 and 106785. JHN received research grant support and professional speaking honoraria from Abbott and Roche Diagnostics. EKS was partially supported by the VA MERIT award (#1I01CX001825) from the United States Department of Veterans Affairs Clinical Sciences Research and Development Service. EKS has received unrestricted research support from Dexcom (to Baltimore VA Medical Center and to University of Maryland) for the conduction of clinical trials. JE’s efforts were supported by the Food and Drug Administration under award number P50FD006425 for The West Coast Consortium for Technology & Innovation in Pediatrics. The funding source had no involvement in the development of this manuscript or in the decision to submit the paper for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the FDA. BB is on medical advisory boards for Convatec, Medtronic, and Tolerion. GF is general manager and medical director of the Insitute for Diabetes Technology (Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany), which carries out clinical studies on the evaluation of BG meters, with CGM systems and medical devices for diabetes therapy on its own initiative and on behalf of various companies. GF has received speakers’ honoraria or consulting fees from Abbott, Ascensia, Dexcom, i-SENS, LifeScan, Menarini Diagnostics, Metronom Health, Novo Nordisk, PharmaSense, Roche, Sanofi, Sensile, and Ypsomed. RH reports having received speaker honoraria from Eli Lilly and Novo Nordisk, serving on advisory panel for Eli Lilly and Novo Nordisk; receiving license fees from BBraun and Medtronic; having served as a consultant to BBraun, patents related to closed-loop insulin delivery, and director at CamDiab. DNO has served on advisory boards for Abbott, Medtronic, MSD, Novo, Roche, and Sanofi; received research support from Medtronic, Novo, Roche, Lilly, and Sanofi; and travel support from Novo and MSD. AW received research support from United Health Group and Eli Lilly, and received research funding from Novo Nordisk. DCK is a consultant to Dexcom, Eoflow, Fractyl, Lifecare, Novo Nordisk, Roche Diagnostics, and Thirdwayv. RJR, SL, NEP, DGA, LB, CBC, LH, NM, TN, MR, DBS, JJS, TS, JYZ, and JH have nothing to disclose.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by grants from Abbott Diabetes Care, Dexcom, and Medtronic.
Publisher Copyright:
© 2020 Diabetes Technology Society.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - COVID-19
KW - automated insulin dosing
KW - continuous glucose monitor
KW - guideline
KW - hospital
UR - http://www.scopus.com/inward/record.url?scp=85091686008&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85091686008&partnerID=8YFLogxK
U2 - 10.1177/1932296820954163
DO - 10.1177/1932296820954163
M3 - Article
C2 - 32985262
AN - SCOPUS:85091686008
VL - 14
SP - 1035
EP - 1064
JO - Journal of diabetes science and technology
JF - Journal of diabetes science and technology
SN - 1932-2968
IS - 6
ER -
