Continuous Glucose Monitoring

Hi Kelly, 

I work for Medtronic and we have a CGM that the patient wears on their stomach or back, there is a small eyelash that sits in their interstitial fluid and takes a glucose reading every 5 minutes. They can wear the device up to a week. If you'd like to chat more about this, you can email me at Carissa.j.burton@medtronic.com

Hope this helps!

Carissa Burton 

Hi Kelly -   Be careful and do your home work.  I do not believe these devices are approved for POC Laboratory type instruments and do not replace a lab value(s) nor are approved for use in this manner.   These devices if I remember, would supplement  a person's home glucose meter and provide a snap shot of about 7-14 days' worth of glucose trends for that patient.  That person would be a known diabetic. So this device is really only to improve diabetes management for those already diagnosed.  I could see  this would be used  only through the physician practice, not with acute inpatients, critically ill or emergent patients, however there may be other manufactures out there with more and new emerging devices.  I just briefly looked into a couple of devices because my own institutions' purchasing department were looking at this type of device also; and did not find any mention where this is for inpatient use, especially when the rate of false low readings below 60 mg/dl is 40% (later finding these patients in the studied group actual glucose read between 81-160.) Not to mention this doesn't look very cost effective for inpatient use. Its $$$.

Gina,

Thanks and agree with all you have stated.  I was mentioning in context of the patient type that was mentioned - amputee, unable to obtain capillary, venous or required repeat arterial collections.  This method is much more geared toward the outpatient/physician practice area.  It may not be possible to use on IP's who are critically ill, etc., but is worth mentioning.  There may be facilities who are willing to perform evaluation for such use.

It is always a challenge to find suitable, effective and efficient methods to monitor glucose levels on these unusual patients.

Great dialogue!

Thanks!

I appreciate the insight. That is why I like to post these types of question to this group.

I have been doing my homework and then some.  And I haven't been able to find an alternative to finger-stick capillary, neonate heel stick capillary, venous or arterial specimen types that are approved for hospital use. Which is why I started looking at CGM's. But I can not find any CGM's out there that can be used with dialysis patient and that do not require finger-stick calibrations.

The patient types were are looking at are amputees on dialysis. The physicians do not want to insert any "lines" and compromise vessel access. But at this point shy of validating an instrument for off-label use, I can not seem to find any way around having "lines' inserted on these patients.

I was hoping someone out in the POC world may have discovered a better option for these unusual situations.

Any suggestions are always appreciated.

Thank You Again,

Kelly

Thanks for sharing that information, Gina.

I wanted to thank everyone for their insight and information. After much research it appears that there is not a CGM device that is approved for Hospital use.

It looks as though I either need to attempt to validate an instrument for off label use(which does not make me very comfortable), get the patients to agree to very frequent venous draws or get the physicians on board with having "lines" placed on these patients. The clinical staff will not like these options but for now I feel they are the only options that would be safe for these patients.

Thank You Again!!

Kelly