CGM in Emergency Vascular Surgery

8→9

Of 11 standards above 80% compliance

Consecutive patients, two cycles

>80%

Patients with hypoglycaemia avoided

Problem

Diabetic patients undergoing emergency vascular surgery need close perioperative glucose control, but adherence to national standards on the ward is rarely measured.

Approach

Led, as first author, a two-cycle audit of 90 consecutive perioperative diabetic patients (45 per cycle) against 11 Joint British Diabetes Societies standards, introducing continuous glucose monitoring between cycles.

Outcome

Standards met at over 80% compliance rose from 8 to 9 of 11. Hourly glucose monitoring, the weakest domain, improved to over 75% among CGM users, and hypoglycaemia was avoided in over 80% of patients. Poster presented at the Vascular Society AGM 2024.

Full article

Context

These patients face higher complication rates and wide variability in perioperative insulin management. I ran this audit as an FY1 doctor at Hull Royal Infirmary.

Method

Cycle one set the baseline: compliance was good in most areas, with a clear gap in hourly glucose monitoring.

CGM is standard in outpatient diabetic care but rarely used for surgical inpatients.

Takeaway

The sensor technology was not new. The guidelines were not new. What was new was applying an existing tool in a setting where it had not been tried, measuring the result, and showing that the value lay in the workflow change rather than the device.