Continuous Glucose Monitoring for High-Risk Type 2 Diabetes in the Hospital: Cloud-Based Real-Time Glucose Evaluation and Management System (Cyber GEMS)
医院高风险 2 型糖尿病的连续血糖监测:基于云的实时血糖评估和管理系统 (Cyber GEMS)
基本信息
- 批准号:10641776
- 负责人:
- 金额:$ 61.76万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-07-27 至 2026-05-31
- 项目状态:未结题
- 来源:
- 关键词:AdoptedAdoptionAdultAdvanced Practice NurseAlgorithm DesignAlgorithmsAmbulatory MonitoringBlindedBlood GlucoseCaliforniaCardiacClinicalClinical TrialsCommunicationComputerized Medical RecordContinuous Glucose MonitorCost AnalysisCoupledDangerousnessDataDevicesDiabetes MellitusEffectivenessEffectiveness of InterventionsEligibility DeterminationEnvironmentEvaluationEventGlucoseGoalsHandHealth Care CostsHealth systemHealthcare SystemsHispanicHispanic PopulationsHospitalistsHospitalizationHospitalsHuman ResourcesHyperglycemiaHypoglycemiaIncentivesInfectionInfection ControlInfrastructureInsulinInternationalInterventionLength of StayLow incomeMaintenanceMethodsMexicoMonitorNeurologicNon-Insulin-Dependent Diabetes MellitusNosocomial InfectionsNot Hispanic or LatinoNotificationNursing StaffOutcomeOutcomes ResearchPatientsPhasePopulationPopulations at RiskProcessProtocols documentationRandomized, Controlled TrialsReach, Effectiveness, Adoption, Implementation, and MaintenanceRecommendationResearchResourcesSpecialistStandardizationStratificationStreamSystemTelemetryTestingTimeWorkblood glucose regulationcardiometabolismclinical riskcloud basedcost effectivenessdashboarddesigndiabetes controldiabetes mellitus nursingdigitaldigital monitoringeffectiveness evaluationexperienceglucose monitorglycemic controlhigh riskhigh risk populationhospital carehospital readmissionimprovedimproved outcomeinfection rateinfection riskinnovationmortalitynovelpoint of carepoint of care testingpreventremote monitoringsafety netsuccesstransmission processtreatment as usualtreatment optimizationtrendwireless transmission
项目摘要
7. Project Summary/Abstract
There is strong evidence that poor glycemic control in the hospital is common. Given the known
consequences of uncontrolled blood sugars during a hospitalization (e.g., infection, serious neurological
and cardiac complications, mortality, longer lengths of stay, readmissions, higher healthcare costs),
health systems devote significant resources to developing protocols for improving glucometrics.
Surprisingly, despite the widespread use and demonstrated effectiveness of continuous glucose
monitoring (CGM) for ambulatory glucose management, CGMs are not currently used in any US
hospital. Therefore, the long-term goal to develop Cloud-Based Real-Time Glucose Evaluation and
Management System (Cyber GEMS) is to provide an effective, real-time solution to augment existing
processes, to provide a valuable test of real-world effectiveness, while capitalizing on standardized
algorithms to facilitate sustainability and scalability to other systems and at-risk populations. The
innovative intervention will enable hospital care teams to take immediate steps based on the wireless
transmission of glucose data from the Dexcom G6 device, sent to a Digital Dashboard, where
integration with existing real-world hospital processes can provide immediate prioritization to prevent or
correct impending hypoglycemia and severe hyperglycemic events. The first step toward this long-term
goal is a randomized controlled trial, defined as a Phase III/IV definitive clinical trial that in turn
establishes efficacy and effectiveness of this intervention. Aim 1 will establish the effectiveness of
Cyber GEMS versus Usual Care (UC) in increasing the % time patients are in-range and decreasing %
time in hypoglycemia and severe hyperglycemia during hospitalization. Simultaneously, Aim 2 will
evaluate the effectiveness of Cyber GEMS versus UC in decreasing hospital-acquired infection risk.
The described Digital Dashboard is progressive, as it facilitates real-time, wireless transmission of
glucose data of a large volume of patients simultaneously; automatically identifies and prioritizes
patients for intervention; and detects potentially dangerous hypoglycemic episodes – all at a reduced
burden than current methods of stratification and review. The uninterrupted coverage by telemetry,
coupled with efficient and remote diabetes specialist oversight in Cyber GEMS is a scalable, novel,
team-based approach to maximize the use of continuously streaming CGM data for optimal glucose
management. The work proposed pushes the limits of these challenges by providing evidence,
identified by a team-based approach to glucose management in an underserved and understudied
population, supplementing prior data designed to improve outcomes among high-risk patients with T2D
and related cardiometabolic conditions.
7.项目总结/摘要
有强有力的证据表明,在医院血糖控制不良是常见的。鉴于已知
住院期间血糖不受控制的后果(例如,严重神经系统感染
和心脏并发症、死亡率、住院时间更长、再入院、医疗费用更高),
卫生系统投入大量资源来制定改进血糖测定的规程。
令人惊讶的是,尽管连续葡萄糖的广泛使用和有效性,
动态血糖管理的动态血糖监测(CGM),CGM目前尚未在任何美国使用
医院因此,开发基于云的实时葡萄糖评估和
管理系统(Cyber GEMS)是提供一个有效的,实时的解决方案,以增加现有的
过程,以提供对现实世界有效性的有价值的测试,同时利用标准化的
算法,以促进其他系统和风险人群的可持续性和可扩展性。的
创新的干预措施将使医院护理团队能够立即采取措施,
从Dexcom G6设备传输葡萄糖数据,发送到数字仪表板,其中
与现有的现实世界的医院流程的集成可以提供即时的优先级,以防止或
纠正即将发生的低血糖和严重高血糖事件。第一步,实现长期
目标是随机对照试验,定义为III/IV期确定性临床试验,
确定这种干预的有效性和效果。目标1将确定以下方面的有效性:
Cyber GEMS与家庭护理(UC)相比,患者在范围内的时间百分比增加,患者在范围内的时间百分比减少
住院期间发生低血糖和严重高血糖的时间。同时,Aim 2将
评估Cyber GEMS与UC在降低医院获得性感染风险方面的有效性。
所描述的数字仪表板是渐进式的,因为它促进了信息的实时无线传输。
同时采集大量患者的血糖数据;自动识别并确定优先级
患者进行干预;并检测潜在危险的低血糖发作-所有这些都在降低
负担比目前的方法分层和审查。不间断的遥测覆盖,
加上有效的和远程糖尿病专家监督在网络GEMS是一个可扩展的,新颖的,
基于团队的方法,最大限度地利用连续流式CGM数据,以获得最佳血糖
管理所提出的工作通过提供证据,
通过基于团队的葡萄糖管理方法在服务不足和研究不足的
人群,补充旨在改善T2 D高风险患者结局的既往数据
以及相关的心脏代谢疾病。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Adelaide L Fortmann其他文献
Adelaide L Fortmann的其他文献
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{{ truncateString('Adelaide L Fortmann', 18)}}的其他基金
Continuous Glucose Monitoring for High-Risk Type 2 Diabetes in the Hospital: Cloud-Based Real-Time Glucose Evaluation and Management System (Cyber GEMS)
医院高风险 2 型糖尿病的连续血糖监测:基于云的实时血糖评估和管理系统 (Cyber GEMS)
- 批准号:
10457241 - 财政年份:2021
- 资助金额:
$ 61.76万 - 项目类别:
Identification of Sex Differences in Glycemic Control and Development of a Continuous Glucose Monitoring (CGM) Benefit Index for Optimization of Glycemic Management in the Hospital
识别血糖控制中的性别差异并开发连续血糖监测 (CGM) 效益指数以优化医院血糖管理
- 批准号:
10771887 - 财政年份:2021
- 资助金额:
$ 61.76万 - 项目类别:
ACT1VATE: Addressing Emotional Distress to Improve Outcomes among Diverse Adults with Type 1 Diabetes
ACT1VATE:解决情绪困扰,改善不同类型 1 型糖尿病成人的预后
- 批准号:
10475198 - 财政年份:2020
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$ 61.76万 - 项目类别:
ACT1VATE: Addressing Emotional Distress to Improve Outcomes among Diverse Adults with Type 1 Diabetes
ACT1VATE:解决情绪困扰,改善不同类型 1 型糖尿病成人的预后
- 批准号:
10264163 - 财政年份:2020
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$ 61.76万 - 项目类别:
ACT1VATE: Addressing Emotional Distress to Improve Outcomes among Diverse Adults with Type 1 Diabetes
ACT1VATE:解决情绪困扰,改善不同类型 1 型糖尿病成人的预后
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Dulce Digital-COVID Aware (DD-CA) discharge texting platform for US/Mexico border Hispanics with diabetes + COVID-19
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