Steady Glucose Screens Can Optimize Diabetic Ketoacidosis Administration

By Ananya Sen

Diabetic ketoacidosis is a standard extreme complication of diabetes, which develops when the physique can’t produce sufficient insulin.

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

Concerningly, this situation accounts for greater than 500,000 hospital days per 12 months, typically within the intensive care unit, with an estimated price of $2.4 billion.

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

“Although DKA is a condition with low mortality, patients often end up in the ICU, primarily due to the need for frequent glucose checks. There is a mismatch between relative risk of death from DKA compared to the other conditions we see in the ICU,” mentioned Nate Haas, M.D., scientific assistant professor of emergency drugs.

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

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 danger of dying from DKA in comparison with the opposite circumstances we see within the ICU.

-Nate Haas, M.D.

In distinction, a steady glucose monitor is a secure and cost-effective sensor that’s quickly 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.

“Prior to this study, there were concerns that continuous glucose monitors may not be as accurate during DKA because they rely on interstitial fluid, which surrounds your cells. Since patients with DKA are severely dehydrated, it was unclear whether the monitors would be as accurate,” Haas mentioned.

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

Utilizing 334 paired measurements, the research discovered that steady glucose screens remained correct throughout DKA. Promisingly, they have been capable of extra rapidly determine drops in blood glucose ranges and have been clinically similar to the glucose values 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 fingersticks needed, simplify management, and prevent the need for ICU admission for DKA in the future,” Haas mentioned.

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

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

Further authors: Lynn Ang, Nazanene H. Esfandiari, Ahsan M. Khan, James A. Cranford, Ashley Cohen, Jordan Promote, Mostafa Abdel-Hamid, Kevin E. Romanchik and Frederick Ok. Korley.

Funding/disclosures: The 2023 Society for Educational Emergency Drugs Basis Superior Analysis Methodology Analysis and Design Pilot Grant with a price share from the Division of Emergency Drugs on the College of Michigan.

Paper cited: “Analytical Accuracy of a Continuous Glucose Monitor in Adult Diabetic Ketoacidosis,” CHEST Crucial Care. DOI: 10.1016/j.chstcc.2024.100109

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