Project summary
People with diabetes are three times more likely to go to hospital at some stage in life than people without diabetes. Of these, many will be very unwell in an Intensive Care Unit (ICU). We know that continuous glucose monitoring (CGM) tech reduces low blood sugars in people with diabetes who aren’t in hospital. Dr Avari will explore whether CGM can prevent severely low blood sugars in critically ill people with diabetes in hospital. This research could make CGM use part of routine care to protect the health of this vulnerable group.
Background to research
People living with type 1 diabetes, and some people with type 2, use continuous glucose monitoring (CGM) tech to help manage their blood sugars.
But it’s much harder to manage blood sugars in hospital. Cases of low blood sugars are three times higher in people admitted to Intensive Care Units (ICUs) than other hospital areas. If blood sugars are too high or too low, it puts people with diabetes at risk of harmful complications.
To manage blood sugars in hospital, nurses carry out finger prick tests, which can be painful, or take blood samples. These methods only provide a snapshot of sugar levels at any one time - they don’t give continuous readings like CGM. This means there are gaps in blood sugar data and care may not be provided in a timely manner.
Research has shown that using CGM to monitor the blood sugars of people in ICUs is safe and accurate and can improve blood sugar management. But no studies have been conducted in an NHS setting, until now.
Research aims
Dr Avari is investigating whether CGM can safely and effectively manage blood sugar levels in very unwell people with diabetes in hospital who are being treated with insulin.
She’ll first provide people who have hyperglycaemia (high blood sugars) in the ICU with CGM tech (the Dexcom G7 system). Their blood will be tested using standard care (finger pricking or blood samples). The Dexcom G7 will continuously upload data onto smartphones so nurses can see blood sugar data in real-time and adjust insulin treatment accordingly. This will help Dr Avari check how the tech’s working.
Then Dr Avari will recruit adults with diabetes at three clinical sites, who’ll either receive care using the Dexcom G7 or standard care. To see how well CGM manages blood sugars, she’ll compare numbers of low blood sugars in each group. Dr Avari will also ask the hospital staff how easy it is to use CGM tech.
Potential benefit to people with diabetes
We know that CGM can help people with diabetes to manage their blood sugars. But we don’t know how well CGM can manage blood sugars in critically unwell people with diabetes in hospital. This research will show whether CGM can help to prevent severe episodes of low blood sugars in hospital. Its results will be used to plan a bigger study at several clinical sites in the UK. This could open the door to CGM becoming part of routine care to protect the health of very unwell people with diabetes in hospital.
