The Devil Is in the Details: Use, Limitations, and Implementation of Continuous Glucose Monitoring in the Inpatient Setting.

Until recently, continuous glucose monitoring (CGM) systems were reserved for use in the outpatient setting or for investigational purposes in hospitalized patients. However, during the coronavirus disease 2019 pandemic, use of CGM in the inpatient setting has grown rapidly. This review outlines important details related to the accuracy, limitations, and implementation of, as well as necessary staff education for, inpatient CGM use and offers a glimpse into the future of CGM in the inpatient setting.

The Rapid Implementation of an Innovative Virtual Diabetes Boot Camp Program: Case Study.

Background: COVID-19 disrupted health care, causing a decline in the health of patients with chronic diseases and a need to reimagine diabetes care. With the advances in telehealth programs, there is a need to effectively implement programs that meet the needs of patients quickly.

Objective: The aim of this paper was to create a virtual boot camp program for patients with diabetes, in 3 months, from project conception to the enrollment of our first patients.

A Low-Power, Low-Cost Ingestible and Wearable Sensing Platform to Measure Medication Adherence and Physiological Signals.

In this paper, we present a novel Digital Medicines program used for reviewing medication adherence. The program is comprised of an ingestible sensor embedded inside medication and a wearable sensor or patch worn on the skin of the patient. The ingestible sensor activates upon contact with gastric fluids and communicates information about the ingested drug to the patch.

Novel Ideas and Team Approach to Improve Outpatient Diabetes Control in a Large Hospital System.

"Quality Improvement Success Stories" are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc. (ACP), and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions.

Effects of Long-Term Combination LT4 and LT3 Therapy for Improving Hypothyroidism and Overall Quality of Life.

Objectives: Hypothyroidism results in decreased mood and neurocognition, weight gain, fatigue, and many other undesirable symptoms. The American Association of Clinical Endocrinologists, the American Thyroid Association (ATA), and The Endocrine Society recommend levothyroxine (LT4) monotherapy as the treatment for hypothyroidism; however, after years of monotherapy, some patients continue to experience impaired quality of life. Combination LT4 and synthetic liothyronine (LT3) therapy or the use of desiccated thyroid extract (DTE), has not been suggested for this indication based on short-duration studies with no significant benefits.

Improving adherence and outcomes in diabetic patients.

Objective: Nonadherence in diabetes is a problem leading to wasted resources and preventable deaths each year. Remedies for diminishing nonadherence are many but marginally effective, and outcomes remain suboptimal.

Aim: The aim of this study was to test a new iOS "app", PatientPartner.

Decreased mortality with tight glycemic control in critically ill patients: a retrospective analysis in a large community hospital system.

Objective: To measure the efficacy and possible adverse consequences of tight blood glucose (BG) control when compared to relaxed control.

Methods: A retrospective, observational study was conducted at a community-based teaching hospital system among adult, nonmaternity hospitalized patients admitted to the intensive care unit (ICU). Tight glycemic control of BG was compared with less strict BG control, and the following outcome measurements were compared: BG, average length of stay (ALOS), severe hypoglycemia, and mortality.

Perioperative glycemic control: use of a hospital-wide protocol to safely improve hyperglycemia.

Perioperative hyperglycemia impairs immunity and contributes to increased susceptibility to infection, higher incidence of multiorgan dysfunction, and greater mortality. Strict glycemic control is associated with lower infection rates, decreased length of stay (LOS), and faster recovery. A protocol that standardized preoperative education, testing, and treatment of elevated blood glucose (BG) safely improved perioperative glycemic control.

Improving ambulatory diabetes care in high-risk racial minorities: use of culture-specific education and close follow-up.

Objective: To describe a project aimed at improving diabetes care in the ambulatory setting among 2 high-risk racial minorities (African American and Hispanic patients) by using culture-specific education provided by trained diabetes educators from the same racial groups as the targeted patients.

Methods: Two nurse educators, 1 Hispanic and 1 African American, completed a standardized chronic disease management program, as did 2 patients with diabetes from each of the aforementioned ethnic groups in preparation for training other patients. The study patients participated in group classes or one-on-one sessions to learn about appropriate management of their diabetes, related complications, and improved lifestyle habits.

Effectiveness and long-term safety of thiazolidinediones and metformin in renal transplant recipients.

Objective: To investigate the long-term safety and effectiveness of thiazolidinediones and metformin in renal transplant recipients with posttransplant diabetes mellitus (PTDM) or preexisting diabetes mellitus (DM).

Methods: Retrospective chart review was performed for renal transplant recipients with PTDM or preexisting DM followed up during the years 2000-2006. Data collected included baseline characteristics; glomerular filtration rate (GFR); creatinine; hemoglobin A1c; and development of congestive heart failure, edema, and liver function abnormalities.

Inpatient point-of-care bedside glucose testing: preliminary data on use of connectivity informatics to measure hospital glycemic control.

Background: Point-of-care (POC) bedside glucose (BG) testing and timely evaluation of its effectiveness are important components of hospital inpatient glycemic control programs. We describe a new technology to evaluate inpatient POC-BG testing and report preliminary results of inpatient glycemic control from 10 U.S.

Improved perioperative glycemic control by continuous insulin infusion under supervision of an endocrinologist does not increase costs in patients with diabetes.

Objective: To evaluate whether glycemic control can be improved perioperatively by implementing an insulin infusion protocol for patients with diabetes undergoing coronary artery bypass graft (CABG) surgery, without creating an additional financial burden. We also evaluated impact of such a protocol on hospital length of stay (LOS) and development of deep sternal wound infections (DSWI).

Methods: We developed an insulin infusion glycemic control protocol (IGCP) under supervision and consultation of an endocrinologist.