Glucose as the Fifth Vital Sign: A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Hospital Setting.

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The current standard for hospital glucose management is point-of-care (POC) testing. We conducted a randomized controlled trial of real-time CGM (RT-CGM) compared with POC in a non-ICU hospital setting.A total of 110 adults with type 2 diabetes (T2D) 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.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 median time in range 70-250 mg/dL (+11.26%) compared with UC (Ps < 0.05). Percentage of time in hypoglycemia was very low.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.

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