Expanding Use of CGM in Critical Care: Impact on Nurse Work Patterns and Patient Outcomes

Expanding Use of Continuous Glucose Monitoring Beyond COVID in Critical Care: Impact on Nurse Work Patterns and Patient Outcomes

The primary objective of this implementation study is to assess the feasibility of real time continuous glucose monitoring (CGM) implementation using a CGM plus (+) point-of-care (POC) protocol among patients on IV insulin or those with hyperglycemia (>250mg/dl) in the critical care hospital environments.

This study analyzes the feasibility of inpatient real time CGM implementation through the use of a CGM + POC protocol as routine care for glycemic monitoring among patients on IV insulin or those with hyperglycemia (>250mg/dl). The investigators will examine the effects on medical intensive care (MICU) patient's (N=100) glycemic control compared to matched historical control patients (N=100) from the MICU who received fingerstick POC.

Inclusion Criteria:

• adults >18 years old,
• admitted to Ohio State University Wexner Medical Center MICU and
• have hyperglycemia (glucose >250mg/dl) or are currently on IV insulin.

Exclusion Criteria:

• Current COVID-19 infection,
• Refractory shock (Levophed dose >0.5 mcg/kg/min or equivalent)
• Actively being treated for diabetic ketoacidosis (DKA)
• Actively being treated for hyperosmolar non-ketoacidosis (HONK)
• Pitting edema, anasarca, blue or purple discoloration to left upper extremity
• Treated with high dose acetaminophen (>1 gram Q6 hours)
• Treated with hydroxyurea
• Are pregnant, patients
• Using home insulin pump therapy during hospitalization, or
• Reside in a corrections institution.