Digitally enabled flash glucose monitoring for inpatients with COVID-19: Feasibility and pilot implementation in a teaching NHS Hospital in the UK

Tim Robbins, Adam Hopper, Jack Brophy, Elle Pearson, Risheka Suthantirakumar, Maariyah Vankad, Natalie Igharo, Sud Baitule, Cain C.T. Clark, Theodoros N. Arvanitis, Sailesh Sankar, Ioannis Kyrou, Harpal Randeva

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    Abstract

    Background: COVID-19 placed significant challenges on healthcare systems. People with diabetes are at high risk of severe COVID-19 with poor outcomes. We describe the first reported use of inpatient digital flash glucose monitoring devices in a UK NHS hospital to support management of people with diabetes hospitalized for COVID-19. Methods: Inpatients at University Hospitals Coventry & Warwickshire (UHCW) NHS Trust with COVID-19 and diabetes were considered for digitally enabled flash glucose monitoring during their hospitalization. Glucose monitoring data were analysed, and potential associations were explored between relevant parameters, including time in hypoglycaemia, hyperglycaemia, and in range, glycated haemoglobin (HbA1c), average glucose, body mass index (BMI), and length of stay. Results: During this pilot, digital flash glucose monitoring devices were offered to 25 inpatients, of whom 20 (type 2/type 1: 19/1; mean age: 70.6 years; mean HbA1c: 68.2 mmol/mol; mean BMI: 28.2 kg/m2) accepted and used these (80% uptake). In total, over 2788 h of flash glucose monitoring were recorded for these inpatients with COVID-19 and diabetes. Length of stay was not associated with any of the studied variables (all p-values >0.05). Percentage of time in hyperglycaemia exhibited significant associations with both percentage of time in hypoglycaemia and percentage of time in range, as well as with HbA1c (all p-values <0.05). The average glucose was significantly associated with percentage of time in hypoglycaemia, percentage of time in range, and HbA1c (all p-values <0.05). Discussion: We report the first pilot inpatient use of digital flash glucose monitors in an NHS hospital to support care of inpatients with diabetes and COVID-19. Overall, there are strong arguments for the inpatient use of these devices in the COVID-19 setting, and the findings of this pilot demonstrate feasibility of this digitally enabled approach and support wider use for inpatients with diabetes and COVID-19.

    Original languageEnglish
    Pages (from-to)1-7
    Number of pages7
    JournalDigital Health
    Volume8
    DOIs
    Publication statusPublished - 7 Jan 2022

    Bibliographical note

    https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

    Funder

    The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the HDR UK (grant number HDR-3001, COVID-19 Action Fund). T. Robbins has received support from the Winston Churchill Memorial Fellowship Trust. Theodoros N. Arvanitis is partially funded by HDR UK. HDR UK is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome Trust.

    Funding Information:
    The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the HDR UK (grant number HDR-3001, COVID-19 Action Fund). T. Robbins has received support from the Winston Churchill Memorial Fellowship Trust. Theodoros N. Arvanitis is partially funded by HDR UK. HDR UK is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Of?ce of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome Trust.

    Keywords

    • COVID-19
    • diabetes
    • digital health
    • flash glucose monitoring
    • inpatient care

    ASJC Scopus subject areas

    • Health Policy
    • Health Informatics
    • Computer Science Applications
    • Health Information Management

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