Steady glucose screens present promise in managing diabetic ketoacidosis

Diabetic ketoacidosis is a typical extreme complication of diabetes, which develops when the physique cannot produce sufficient insulin.

Throughout DKA the physique begins breaking down fats, inflicting a buildup of acids within the bloodstream. The signs typically embody thirst, weak point, nausea and confusion.

Concerningly, this situation accounts for greater than 500,000 hospital days per yr, typically within the intensive care unit, with an estimated price of $2.4 billion.

In a research, printed in CHEST Important Care, College of Michigan researchers present that utilizing steady glucose screens may help measure glucose precisely throughout DKA and probably stop ICUs from being overwhelmed.

Though DKA is a situation with low mortality, sufferers typically find yourself within the ICU, primarily because of the want for frequent glucose checks. There’s a mismatch between relative threat of demise from DKA in comparison with the opposite situations we see within the ICU.”

Nate Haas, M.D., medical assistant professor of emergency drugs

Administration of DKA requires frequent blood glucose measurements through fingerstick to information therapy, usually carried out as soon as per hour, which may be burdensome for nurses and trigger affected person discomfort.

In distinction, a steady glucose monitor is a protected and cost-effective sensor that’s briefly positioned on the pores and skin of the affected person’s stomach or arm. 

Nevertheless, the good thing about utilizing it throughout DKA was unknown.

“Previous to this research, there have been considerations that steady glucose screens might not be as correct throughout DKA as a result of they depend on interstitial fluid, which surrounds your cells. Since sufferers with DKA are severely dehydrated, it was unclear whether or not the screens could be as correct,” Haas stated.

The research, which was performed from March to August 2023, targeted on 20 sufferers. The workforce in contrast glucose readings taken concurrently from steady glucose screens and customary, hourly fingerstick glucose checks.

Utilizing 334 paired measurements, the research discovered that steady glucose screens remained correct throughout DKA. Promisingly, they have been in a position to extra shortly establish drops in blood glucose ranges and have been clinically akin to the glucose values obtained from hourly finger sticks. 

“This is step one in enhancing affected person outcomes, affected person expertise, and lowering useful resource utilization for the widespread, pricey situation of DKA. By utilizing this device, we will scale back the variety of fingersticks wanted, simplify administration, and forestall the necessity for ICU admission for DKA sooner or later,” Haas stated.

He’s working to develop a medical trial with collaborators from throughout the nation to additional assess the usage of steady glucose monitor-guided DKA administration.

“This work required a big, multidisciplinary group from endocrinology, emergency drugs, nursing and biostatistics, and I am hoping that our future work will assist scale back ICU overcrowding and enhance affected person outcomes,” Haas stated.