682-P: Feasibility of CGM Use in Basal-Bolus Insulin Therapy with an Electronic Decision Support System in Hospitalized Patients

Abstract

Continuous glucose monitoring (CGM) provides a more holistic picture of glycemic control than capillary blood glucose (BG) measurements. We simulated CGM use with a clinical decision support system (cDSS) with a basal-bolus insulin algorithm using CGM values recorded at the same time (CGM0) vs. 15 minutes after the BG measurement (CGM+15) to simulate typical CGM trend information. Data of 30 inpatients with T2D (age: 74.1±10.9 years, female: 60 %, Caucasian: 100 %, BMI: 28.6±5.6 kg/m2, diabetes duration: 13.2±11.6 years, HbA1c: 72±22 mmol/mol, stay duration: 8.2±3.7 days) were used. Simulation results were analysed for insulin doses, overall glycemic control, and potentially avoidable hypoglycemic events (PAHE) : those occurring within 3 hours of a bolus insulin injection when the suggested dose based on CGM was lower. Glucose levels and insulin doses were lower when using CGM. Glucose differences were mainly due to nocturnal hypoglycemia undetected by BG (Table 1) . 36 PAHEs occurred in 17 patients with CGM0 vs. 38 PAHEs in patients with CGM+15. In the simulation, lower CGM readings and undetected nocturnal hypoglycemia resulted in lower insulin doses (single and total daily doses) . Consequently, there were hypoglycemic events that could have been avoided had CGM been used. Combining cDSS and CGM is feasible and can facilitate glycemic control whilst avoiding hypoglycemia. Disclosure K.Bytyqi: None. P.M.Baumann: None. D.A.Hochfellner: None. T.Poettler: None. A.Simic: None. P.Beck: Employee; decide Clinical Software GmbH, Stock/Shareholder; decide Clinical Software GmbH. J.K.Mader: Advisory Panel; Abbott Diabetes, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH, Speaker’s Bureau; Abbott Diabetes, Eli Lilly and Company, Medtronic, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH, Servier Laboratories, Stock/Shareholder; decide Clinical Software GmbH.