The devices wirelessly transmit glucose-level readings to a phone or receiver.
Photo: Ben Birchall/PA Wire/Zuma PressHospitals are ordering electronic glucose monitors as a way to limit staff contact with the large portion of contagious Covid-19 patients who have diabetes, in an effort to curb transmission of the disease and conserve scarce protective gear such as face masks.
Doctors and medical-device companies say patients’ use of the wearable monitors in hospitals hard hit by the coronavirus pandemic could reduce the need for nurses to enter a patient’s room several times a day to perform an older method of blood-sugar testing, via manual finger-sticks or blood draws.
Stony Brook University Hospital in Stony Brook, N.Y., began providing some Covid-19 patients with DexCom Inc. monitors this week, said Joshua Miller, medical director of diabetes care for Stony Brook Medicine. For now, staff are still validating the device’s accuracy with blood tests, but Dr. Miller said the goal is to reduce exposure to infected patients and conserve protective gear.
Some hospitals have taken other steps to minimize such contact and conserve protective gear, such as placing medication-infusion pumps outside of patients’ rooms, according to the Institute for Safe Medication Practices.
Frequent glucose tests are critical for diabetes care. They guide decisions on insulin dosing or food intake to ward off dangerous events, including loss of consciousness if glucose levels are too low or too high.
The U.S. Food and Drug Administration this month told DexCom and Abbott Laboratories the agency wouldn’t object if the companies provide the remote monitors to hospitals to support care of Covid-19 patients, an FDA spokeswoman said Wednesday. Previously, the companies didn’t ship them to hospitals because they weren’t FDA-approved for inpatient use, though doctors had discretion to allow patients who already had them to continue using them. The FDA said use of glucose devices that transmit data wirelessly can help reduce risk of viral transmission and preserve protective gear.
More than 125 hospitals have ordered the devices from Abbott Labs, a spokeswoman said. A DexCom spokesman said 86 hospitals have requested the devices.
Hospital use of the devices could have limitations, though, because a patient’s condition and treatment regime could interfere with the sensor’s accuracy, doctors say.
People with diabetes are at higher risk of severe illness and death if infected with the novel coronavirus, which causes Covid-19, and about 28% of hospitalized Covid-19 patients in the U.S. have diabetes, according to the Centers for Disease Control and Prevention.
Continuous glucose monitors are coin-size electronic devices that attach to the abdomen or back of the arm, with a tiny wire sensor inserted under the skin. They track glucose levels and wirelessly transmit the readings to a phone or receiver device.
In a hospital setting, a phone placed outside the patient’s room could track glucose readings; the devices have a feature that could transmit readings to a centralized nurse station.
Doctors say the devices could help with the care of hospitalized Covid-19 patients, but with limitations. They could be useful for less ill patients who don’t need frequent visits, said Lewis Kaplan, president of the Society of Critical Care Medicine and professor of surgery at the Hospital of the University of Pennsylvania.
But critically ill patients rely on nurses for other reasons such as checking ventilators, and glucose monitors likely wouldn’t spare those visits, he said.
Accuracy and reliability can vary by device, and other aspects of treatment could affect the monitors’ performance. The use of the drug acetaminophen, for instance, to reduce fever could cause a monitor to overestimate glucose, which could lead to an insulin overdose.
“There are issues of being critically ill in general that may affect sensor readings, and therefore that is an area of research that needs to be explored,” said Dr. Amish Wallia, a diabetes specialist at Northwestern University’s Feinberg School of Medicine in Chicago.
Dr. Alyson Myers, medical director of inpatient diabetes at North Shore University Hospital in Manhasset, N.Y., said her hospital decided not to use the glucose monitors for Covid-19 patients during most of their hospital stay because of concerns about accuracy. But the hospital will provide them to more stable patients closer to discharge, she said.
Device makers said they asked for FDA permission to ship them to hospitals after doctors started inquiring whether the agency might let them use the monitors on hospitalized patients amid the pandemic.
After the FDA granted permission last week, Abbott received dozens of orders from hospital systems, many in outbreak hot spots, a spokeswoman said. Abbott is donating 25,000 to hospitals on the front lines, she said.
The devices typically cost about $100 to $200 monthly per patient.
DexCom Chief Executive Kevin Sayer said use of the devices could be a “time saver for the health-care staff because they’re going to get automatic data every five minutes,” as well as audible alerts if glucose levels approach unsafe levels.
DexCom started shipping the devices to hospitals in early April and said it plans to produce about 100,000 sensors for hospitalized Covid-19 patients. The company said it plans to donate about 10,000 phones and receivers to hospitals for tracking glucose data remotely.
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Write to Peter Loftus at peter.loftus@wsj.com
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