CENTRALIZED REMOTE MONITORING OF CGM DATA AT DIABETES CAMP MITIGATES HYPOGLYCEMIA
- John Barnard Welsh, United States of America
- Sarah Gleich, United States of America
- Nate Gibson, United States of America
- Margi Battin, United States of America
- Sarah Puhr, United States of America
- Shant Tokatyan, United States of America
- John Barnard Welsh, United States of America
- Tomas Walker, United States of America
- Andrew Balo, United States of America
- Daniel Caruso, United States of America
Abstract
Background and Aims
Continuous glucose monitoring (CGM) is poorly accepted at some American diabetes camps. We evaluated the effectiveness of centralized multiplex monitoring of CGM data overnight at diabetes camp.
Methods
Sixty-nine, insulin-treated campers ages 7-18 years were enrolled at a single, week-long American diabetes camp. All campers performed regularly scheduled fingerstick testing, which informed treatment decisions. Campers that monitored their glucose with fingerstick testing at home were fitted with blinded Dexcom CGM at camp and served as control (n=16). Campers that used Dexcom real-time CGM (rtCGM) systems with sharing functionality at home continued to use their self-supplied system at camp (n=53); shared data from all enrolled campers wearing Dexcom rtCGM systems were simultaneously displayed on an investigational, centralized display in the medical cabin (Figure). The multiplex display alerted camp staff to glucose values <4.4 or >13.8 mmol/L, prompting fingerstick testing outside of scheduled intervals. Campers with <50% data coverage were excluded from the analysis. Overnight (22:00-06:00) CGM data were compared between campers wearing blinded and remotely monitored, rtCGM systems.
Results
Remotely-monitored campers experienced significantly less time <3.0 mmol/L and <3.9 mmol/L and significantly more time in range (TIR; 3.9-10.0 mmol/L) overnight compared to campers monitored with fingerstick testing alone. Overnight hyperglycemia was also lower among remotely-monitored campers (Table). Remote monitoring prompted 73 nocturnal interventions for events that might have otherwise gone undetected.
Conclusions
Centralized multiplex monitoring of rtCGM data at diabetes camp facilitates timely hypoglycemia treatment overnight, may disencumber camp staff, and should be encouraged at all diabetes camps.