LBODP063 The Benefits Of Using Cgm For Intravenous Insulin Therapy

 

Modern glycemic monitoring systems make it easier for doctors and nurses to manage diabetic patients on intravenous insulin therapy in hospital wards and intensive care units (ICU). But one of the most important questions - is it safe for inpatients and usable and cost-effective for hospitals?In our study, we included 1,684 glucometer measurements and 72 cycles (1 cycle = 6 days) of the glycemic monitoring system (Guardian Connect Enlite, Medtronic) in patients on intravenous insulin therapy. Most of them were after pancreatectomy. The mean discrepancy between CGM and glucometer values was -4.1%. According to our study, 77.48% of patients were within the target glycemic range (77.4 mg/dL to 189 mg/dL / 4.3 mmol/L to 10.5 mmol/L), hypoglycemia below 50.4 mg/dL / 2.3 mmol/L was recorded in only 2 cases out of 1648. Results confirm safety and usefulness of glucose monitoring systems in-hospital even in the most severe patients, such as those who were in several days after total pancreatectomy. We compared the cost glucose control using of CGM during of one cycle (6 days) and cost glucose control using glucometer during the same period (6 days) for diabetic patients on intravenous insulin therapy in the inpatient department. We account the cost of the CGM system, batteries, smartphone, glucometer, lancets, test strips, sensors, gloves, antiseptic wipes.

Results

6 days glucose control for diabetic patients on intravenous insulin therapy of using CGM (including 3 times a day using glucometer for calibration of CGM) cost 5422 rubles (68.2 $ / 62.7 €), using only glucometer (18 times a day) cost 6696 rubles. But the most interesting results were after comparing the nurse's time, spent on the glucose control for diabetic patients on intravenous insulin therapy. During 6 days of using of CGM for this patients nurse spends (including 3 times a day using glucometer for calibration of CGM) - 71 minutes. During 6 days of using only glucometer (18 times a day) for this patients nurse spends - 324 minutes. In that way using of CGM for diabetic patients on intravenous insulin therapy save for nurse 253 minutes (nearly 4 hours) during 6 days. The cost of 1 hour of nurse for private hospitals in Moscow in ICU an average 661 rubles (8.3 $ / 7.65 €), in inpatient department - 544 rubles (6.85 $ / 6.3 €). In finally results show a significant cost-effective of using CGM. Nevertheless, well-known the other one of the most important benefit of using CGM devices is that glycemic control with CGM systems improves the quality of life of patients, because no routine finger pricking is required.

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