Continuous Glucose Monitoring (CGM) in patients with diabetic ketoacidosis (DKA)

Continuous glucose monitoring (CGM) is widely used in the outpatient setting but its use is still investigational in the inpatient setting. Several studies showed improvement in detection of hyperglycemic and hypoglycemic episodes with the use of CGM when compared to fingerstick point of care (POC) glucose testing in both the ICU and non-ICU setting. The FDA has allowed use of DEXCOM G6 CGM in hospitalized patients during the COVID-19 pandemic. In a recent pilot study performed during the COVID-19 pandemic done in hospitalized patients in the perioperative period, DEXCOM G6 CGM showed a mean absolute relative difference (MARD) of 9.4% compared to point of care (POC) glucose measurements. Use of continuous glucose monitoring has not been reported in hospitalized patients with DKA. In this project the PI plans to evaluate outcomes of DKA patients treated with CGM in the stepdown unit compared to treatment of DKA in the ICU using hourly POC glucose testing. She also intends to study providers and nurses’ satisfaction with remote glucose monitoring. Furthermore, she will study potential cost savings when DKA patients have glucose levels monitored via DEXCOM G6 CGM compared to hourly fingerstick glucose testing in the ICU setting.