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Robbins T, Hopper A, Brophy J, Pearson E, Suthantirakumar R, Vankad M, Igharo N, Baitule S, Clark CCT, Arvanitis TN, Sankar S, Kyrou I, Randeva H. Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK. Digit Health 2022; 8:20552076211059350. [PMID: 35024157 PMCID: PMC8744149 DOI: 10.1177/20552076211059350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 10/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. METHODS Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay. RESULTS During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values <0.05). The average glucose was significantly associated with percentage of time in hypoglycaemia, percentage of time in range, and HbA1c (all p-values <0.05). DISCUSSION We report the first pilot inpatient use of digital flash glucose monitors in an NHS hospital to support care of inpatients with diabetes and COVID-19. Overall, there are strong arguments for the inpatient use of these devices in the COVID-19 setting, and the findings of this pilot demonstrate feasibility of this digitally enabled approach and support wider use for inpatients with diabetes and COVID-19.
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Affiliation(s)
- Tim Robbins
- University Hospitals Coventry & Warwickshire NHS Trust,
Coventry, UK
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK
| | - Adam Hopper
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Jack Brophy
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Elle Pearson
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Natalie Igharo
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Sud Baitule
- University Hospitals Coventry & Warwickshire NHS Trust,
Coventry, UK
| | | | | | - Sailesh Sankar
- University Hospitals Coventry & Warwickshire NHS Trust,
Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Ioannis Kyrou
- University Hospitals Coventry & Warwickshire NHS Trust,
Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry University, UK
- Aston Medical Research Institute, Aston Medical School, College of
Health and Life Sciences, Aston University, Birmingham, UK
- * Ioannis Kyrou and Harpal Randeva have contributed
equally to this work and are joint senior co-authors
| | - Harpal Randeva
- University Hospitals Coventry & Warwickshire NHS Trust,
Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Aston Medical Research Institute, Aston Medical School, College of
Health and Life Sciences, Aston University, Birmingham, UK
- * Ioannis Kyrou and Harpal Randeva have contributed
equally to this work and are joint senior co-authors
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Bang AT, Bang RA, Baitule S, Deshmukh M, Reddy MH. Burden of morbidities and the unmet need for health care in rural neonates--a prospective observational study in Gadchiroli, India. Indian Pediatr 2001; 38:952-65. [PMID: 11568371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND Majority of the neonates in developing countries are born and cared for in rural homes but the available information is mostly hospital based. OBJECTIVES To estimate: (i) the incidence of various neonatal morbidities and associated case fatality in home-cared rural neonates, (ii) proportion of neonates with indications for health care, and (iii) the proportion who actually receive it. DESIGN Prospective observational study. SETTING Rural homes. METHODS Neonates in 39 study villages in the Gadchiroli district (Maharashtra, India) were observed during one year (1995-96) by 39 trained female village health workers at birth and during neonatal period (0-28 days) by making eight home visits. A physician checked the data and the morbidities were diagnosed by a computer program. Vital statistics in these villages was independently collected. RESULTS Out of 1016 live births, 95% occurred at home and 763 (75&%) neonates were observed. The agreement between observations by health workers and physician was 92%. Total 48.2& neonates suffered high risk morbidities (associated case fatality >10%), 72.2% suffered low risk morbidities, and 17.9% gained inadequate weight (less than 300 g). Seventeen percent neonates developed clinical picture suggestive of sepsis. Though 54.4% neonates had indications for health care and 38 out of total 40 neonatal deaths occurred in these, only 2.6% received medical attention. The neonatal mortality rate was 52.4/1000 live births. CONCLUSION Nearly half of the neonates in rural homes developed high risk morbidities ten times the neonatal morbidity rate and needed health care but practically none received it. The magnitude of care gap suggests an urgent need for developing home-based neonatal care to reduce neonatal morbidities and mortality
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Affiliation(s)
- A T Bang
- SEARCH, P.O. and District: Gadchiroli, 442 605, India.
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