# Continuous Glucose Monitoring in Insulin Treated Hospitalized Veterans with DM2 at Higher Risk for Hypoglycemia

> **NIH VA I01** · BALTIMORE VA MEDICAL CENTER · 2020 · —

## Abstract

More than 25% of patients admitted to general wards/non Intensive Care Unit (non-ICU) setting have a history
of Diabetes Mellitus (DM); and as for 2012, $125 billion dollars were costs associated with hospitalization of
diabetics in the United States (US). Up to 30% of the hospitalized diabetics develop hypoglycemia, a condition
that is associated with higher hospital charges, prolonged length of stay, and increased morbidity and mortality.
Reducing hypoglycemic events in the inpatient setting has led hospitals to develop hypoglycemia prevention
policies; policies which are however limited by the infrequent Point of Care (POC) capillary blood glucose testing
in the general wards. Continuous Glucose Monitoring (CGM) devices represent additional ways to monitor
blood glucose levels. Only a limited number of studies have examined the use of CGM devices in the non-ICU
setting. In all these studies, CGM use was found to be superior compared to POC in hypoglycemia detection.
However, as the results of CGM were blinded (alarms were turned off) for both the investigators and the
participants, interventions to prevent hypoglycemia were not performed. Additionally, one major limitation of
CGM technology is that CGM receiver/monitor needs to be located in the patient's room, due to Bluetooth
Technology signal-strength restrictions, necessitating nurses to enter frequently the patient's room in order to
check CGM glucose values. In the current award application, we describe the development of an innovative
system that allows CGM glucose values to be transmitted from the patients' bedside to a monitoring device that
is located at a central nursing station- a system that we call “Glucose Telemetry System” (GTS).
We propose the conduction of a prospective randomized clinical trial that will examine whether GTS combined
with a hypoglycemia prevention protocol, can decrease hypoglycemia in the medical wards without resulting in
hyperglycemia- resulting to better clinical outcomes. Specifically we hypothesize that: (1) Veterans who will be
randomized to GTS will have less hypoglycemia than Veterans randomized to control group (standard of care);
(2) Veterans who will be randomized to GTS will not experience more frequent hyperglycemia, as a result of
the frequent application of the hypoglycemia prevention protocol, compared to Veterans randomized to the
control group; and (3) GTS use will reduce the frequency of hypoglycemia induced seizures during their
hospitalization – decreasing length of stay and inpatient mortality. We will study 244 Veterans with DM2 who
are at a higher risk for hypoglycemia. Consenting Veterans will be stratified in two groups based on the number
of risk factors of hypoglycemia (≤2 risk factors, ≥3 risk factors); and then further randomized in a 1:1
randomization scheme (122 Veterans randomized to GTS and 122 randomized Veterans to standard of care-
POC blood glucose monitoring). For the participants of the control group, retrospective CGM...

## Key facts

- **NIH application ID:** 9933828
- **Project number:** 5I01CX001825-03
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** Ilias Spanakis
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933828

## Citation

> US National Institutes of Health, RePORTER application 9933828, Continuous Glucose Monitoring in Insulin Treated Hospitalized Veterans with DM2 at Higher Risk for Hypoglycemia (5I01CX001825-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9933828. Licensed CC0.

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