Continuous glucose monitors show promise in treating diabetic ketoacidosis

Continuous glucose monitors show promise in treating diabetic ketoacidosis

Diabetic ketoacidosis is a common serious complication of diabetes that develops when the body cannot produce enough insulin.

During DKA, the body begins to break down fat, causing a buildup of acids in the bloodstream. Symptoms often include thirst, weakness, nausea and confusion.

In terms of this condition, this condition accounts for more than 500,000 days per year in the hospital, often in the intensive care unit, with an estimated cost of $2.4 billion.

In a study published inBreast criticResearchers at the University of Michigan show that the use of continuous glucose monitors can help accurately measure glucose during DKA and potentially overwhelm intensive care.

Although DKA is a low-mortality disease, patients often end up in the intensive care unit, primarily due to the need for frequent glucose testing. There is a disproportion between the relative risk of death from DKA compared to the other conditions we see in the ICU. “

Nate Haas, MD, clinical assistant professor of emergency medicine

Management of DKA requires frequent fingerstick blood glucose measurements to guide treatment, typically performed once per hour. This can be stressful for nurses and cause patient discomfort.

In contrast, a continuous glucose monitor is a safe and inexpensive sensor that is temporarily placed on the skin of the patient's abdomen or arm.

However, the benefit of using the DKA was unknown.

"Prior to this study, there was concern that continuous glucose monitors may not be as accurate during DKA because they rely on interstitial fluid that surrounds your cells. Because patients with DKA are severely dehydrated, it was unclear whether the monitors would be as accurate," Haas said.

The study, conducted from March to August 2023, focused on 20 patients. The team compared glucose values ​​taken simultaneously from continuous glucose monitors and hourly fingerstick glucose checks.

Using 334 paired measurements, the study found that continuous glucose monitors remained accurate during DKA. Promisingly, they were able to identify rapid drops in blood glucose levels and were clinically comparable to the glucose readings obtained from hourly finger sticks.

"This is the first step in improving patient outcomes, patient experience and reducing resource utilization for the common, costly condition of DKA. By using this tool, we can reduce the number of finger sticks needed, simplify management and prevent the need for intensive care unit admission for DKA in the future," said Haas.

He is working on developing a clinical trial with collaborators from across the country to further evaluate the use of continuous glucose monitor-guided DKA management.

“This work required a large, multidisciplinary group from endocrinology, emergency medicine, nursing and biostatistics, and I hope our future work will help reduce ICU overcrowding and improve patient outcomes,” Haas said.

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