Interruption of Continuous Glucose Monitoring: Frequency and Adverse Consequences.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2024-09-01 Epub Date: 2023-02-23 DOI:10.1177/19322968231156572

Alexander M Markov, Petra Krutilova, Andrea E Cedeno, Janet B McGill, Alexis M McKee

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引用次数: 0

Abstract

Background: Removal of diabetes devices, including insulin pumps and continuous glucose monitoring (CGM), is a common practice due to hospital policies, interference with imaging studies, medications, and surgical interventions. Furthermore, these devices are inherently prone to malfunction, adhesive failure, and issues with insertion that can lead to a reduction in wear time. Prescription and dispensing practices provide an exact number of sensors per month without redundancy to account for the realities of daily CGM use.

Methods: A RedCap survey was completed by adult patients with type 1 or type 2 diabetes (T1D or T2D) who utilize CGM followed in the Diabetes Center at Washington University in St Louis.

Results: Of 384 surveys sent, 99 were completed. Participants had a mean age of 54 years, T1D 69%, female 70%, White 96%, non-Hispanic 96%, and a mean duration of diabetes mellitus (DM) 28 years. Of the cohort, 100% used CGM (80.2% Dexcom, 13.5% Freestyle Libre, 6.3% Medtronic), 61% insulin pump, and 41% Hybrid closed-loop (HCL) systems. CGM-related disruption events included device malfunction (in 85.4% of participants), insertion problems (63.5%), and falling off (61.4%). Medical care-related disruption occurred most frequently in the setting of imaging (41.7%), followed by surgery/procedures (11.7%) and hospitalization (4.4%). Adverse glycemic events attributed to CGM disruption, including hyperglycemia and hypoglycemia, occurred ≥4 times in 36.5% and 12.4% of the cohort, respectively.

Conclusions: Disruption in CGM use is common. Lack of redundancy of CGM supplies contributes to care disruption and adverse glycemic events.

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CGM 中断：频率和不良后果。

背景：由于医院政策、影像学检查干扰、药物和手术干预等原因，移除包括胰岛素泵和持续葡萄糖监测（CGM）在内的糖尿病设备是一种常见做法。此外，这些设备本身容易出现故障、粘合剂失效和插入问题，从而导致佩戴时间缩短。处方和配药实践每月提供精确数量的传感器，但没有考虑到 CGM 日常使用的实际情况：圣路易斯华盛顿大学糖尿病中心使用 CGM 的 1 型或 2 型糖尿病（T1D 或 T2D）成年患者填写了 RedCap 调查：在发出的 384 份调查问卷中，有 99 份完成。参与者的平均年龄为 54 岁，T1D 患者占 69%，女性占 70%，白人占 96%，非西班牙裔占 96%，平均糖尿病（DM）病程为 28 年。在这些患者中，100% 使用 CGM（80.2% 使用 Dexcom，13.5% 使用 Freestyle Libre，6.3% 使用 Medtronic），61% 使用胰岛素泵，41% 使用混合闭环 (HCL) 系统。与 CGM 相关的中断事件包括设备故障（85.4% 的参与者）、插入问题（63.5%）和脱落（61.4%）。与医疗相关的中断事件最常发生在影像检查中（41.7%），其次是手术/程序（11.7%）和住院（4.4%）。CGM中断导致的不良血糖事件，包括高血糖和低血糖，分别在36.5%和12.4%的人群中发生≥4次：结论：CGM 使用中断很常见。结论：CGM 使用中断很常见，CGM 供应缺乏冗余是造成护理中断和不良血糖事件的原因之一。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.