None listed
Conditions
Brief summary
This study aims to answer the question: Does use of a glucose telemetry system amongst hospitalised patients with diabetes mellitus treated with multiple daily injections of insulin improve glycaemic outcomes? Eligible participants will be randomised to the glucose telemetry system or to usual care. The glucose telemetry system will provide nursing staff with real-time glucose alerts to facilitate inpatient diabetes care. We will assess whether use of a glucose telemetry system improves inpatient glycaemia. We hypothesise that use of a glucose telemetry system in hospital will improve CGM-based glycaemic outcomes.
Interventions
Glucose telemetry system (GTS): continuous glucose monitor-based in-hospital glucose telemetry system providing real-time high/low-glucose alerts to ward nursing staff, in addition to standard care.
The GTS will be comprised of a Dexcom G7 continuous glucose monitor (CGM) applied to the patient; a CGM receiver (smartphone) by the patient bedside with the Dexcom Clarity app and Dexcom G7 app installed and connected via Bluetooth to the participant’s CGM; and a tablet device at the nursing station
Glucose telemetry system (GTS): continuous glucose monitor-based in-hospital glucose telemetry system providing real-time high/low-glucose alerts to ward nursing staff, in addition to standard care. The GTS will be comprised of a Dexcom G7 continuous glucose monitor (CGM) applied to the patient; a CGM receiver (smartphone) by the patient bedside with the Dexcom Clarity app and Dexcom G7 app installed and connected via Bluetooth to the participant’s CGM; and a tablet device at the nursing station, connected to the hospital Wi-Fi network, with Dexcom Follow app installed. The GTS will be programmed to provide nursing staff with real-time low-glucose and high-glucose alerts through a notification on the tablet device. Additionally, the GTS provides glucose trend arrow displays on the nursing station telemetry monitor which can be used to adjust supplemental doses of insulin as needed. The intervention will run for the duration of the participant's inpatient stay on the study ward, up to a maximum of 10 days.
Sponsors
Melbourne Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Non-critical care adult inpatients Diabetes mellitus (any aetiology) treated with scheduled subcutaneous insulin Admitted under the Endocrinology, Diabetic Foot, Nephrology units on the study ward Anticipated length of stay 3 days or greater
Exclusion criteria
Actively treated hyperosmolar hyperglycaemic state (HHS) Inpatient glucose target range exceeding 13.9 mmol/L Insulin pump use Scheduled for any MRI scan in next 72 hours, or CT scan of the same region where CGM sensor is located Receiving hydroxyurea Receiving icodextrin-containing peritoneal dialysate Palliative care Current active inpatient CGM use Inability to give informed consent Unwilling/unable to wear CGM for duration of the study
Outcome results
None listed