Insulin, COVID-19, Research, Diabetes, CGM

Enhancing Diabetes Care with Technology: Key Strategies from Emory University and Grady Health System

Spurred by the pandemic, health systems and medical facilities are among the most prominent organizations to drive digital transformation. In an effort to enhance patient safety, hospitals leveraged this paradigm shift to develop and deploy innovative solutions that monitor and reduce potential exposure, enable telehealth services and automate sanitization processes.

Researchers also worked around the clock to better understand how COVID-19 affected certain populations and the impact pre-existing conditions may have on the severity of the virus. General medical research doubled over the course of the pandemic and produced over 300,000 articles pertaining to COVID-19.

The adoption of digital solutions and surge in medical research is accelerating a shift in healthcare that employs automation and data to improve services. Research has shown hospitalized COVID-19 patients with a history of diabetes are at a higher risk of severe complications, and to-date, patients with pre-existing diabetes make up 40% of all COVID-19 deaths. This has illuminated the importance of glycemic management within the hospital, including safer management of insulin, and eliminating protocols that rely on sliding scale insulin only.

How hospitals can enhance diabetes care through technology

During a recent webinar hosted by Becker’s Hospital Review, Dr. Francisco Pasquel and I discussed how to optimize glycemic management with technology. Dr. Pasquel elaborated on the five key lessons Emory and Grady Health learned while utilizing technology to enhance patient care:

  1. The FDA allows the use of continuous glucose monitoring during the pandemic.
  2. The implementation of CGM in the Critical Care setting, with a hybrid model of every 6 hours POC testing is feasible. Remote continuous glucose monitoring with EHR documentation to ensure validation of sensor values is feasible and effective in ICU settings. It also allows for the remote evaluation of overall performance metrics.
  3. The teamwork and administrative work of implementation of CGM is challenging but surmountable. We deployed a multidisciplinary team, with expert advice from other facilities that deployed CGM, to implement our hybrid model successfully.
  4. Continuous glucose monitoring reduces personal protective equipment use. During the pandemic, PPE preservation and the need to reduce nurses' exposure to COVID-19 led to strategies to minimize blood glucose checks. Continuous glucose monitoring means abnormal levels can be automatically flagged, and patient discomfort (fingersticks) and blood loss (arterial/venous samples) can be reduced. An average of 20-24 BG checks per day were reduced to about 8 BGs checks per day in patients on IV insulin
  5. Insulin infusions should be administered with written or computerized protocols. Such protocols should allow for infusion rate adjustments and account for glycemic fluctuations and insulin dose targets, unlike the outdated, one-size-fits-all sliding-scale and paper protocols most hospitals use.

Further research is required to determine if people with diabetes that have recovered from COVID will have long-term effects from the virus. However, it is evident that these technological advancements and an industry-wide acceptance of innovative solutions provide patients with the peace of mind that providers have support systems in place to adequately manage their blood sugar levels.


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