Article / Publication

This randomized control trial (RCT) of 185 general medicine and surgery patients with Type 1 and Type 2 diabetes found real-time continuous glucose monitoring (RT-CGM) safe and effective for guiding insulin therapy in hospitalized patients treated with a basal-bolus insulin regimen compared with a point-of-care (POC) group with blinded CGM and POC-guided insulin adjustments. RT- CGM resulted in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemia among patients with one or more hypoglycemic events compared with POC group.  

Spanakis, EK et al. Continuous Glucose Monitoring–Guided Insulin Administration in Hospitalized Patients with Diabetes: A Randomized Clinical Trial. Diabetes Care. Diabetes Care. 2022;45(10):2369-2375.

This publication describes a retrospective analysis of an inpatient real-time continuous glucose monitoring (RT-CGM) program at a community hospital and the accuracy of the system. Authors concluded RT-CGM for inpatient diabetes monitoring is feasible, is a reliable comparator to POC (point-of-care) testing, prevents adverse patient outcomes through safe and timely treatment decisions, and poses minimal risk when used for management decisions. A corresponding podcast is available below.

Baker M, et al. Practical Implementation of Remote Continuous Glucose Monitoring in Hospitalized Patients with Diabetes. Am J Health Syst Pharm. 2022;79(6):452-458.

A clinical practice guideline for inpatient hyperglycemia management from the Endocrine Society was published in The Journal of Clinical Endocrinology & Metabolism. The guideline focuses on hyperglycemia management in non-critically ill hospitalized patients and highlights the use of emerging diabetes technology, including real-time continuous glucose monitoring (RT-CGM), for glycemic management in the hospital. Based on available evidence, the guideline recommends use of RT-CGM with confirmatory point-of-care (POC) testing for insulin dosing decisions in adults with insulin-treated diabetes hospitalized for noncritical illness who are at high risk of hypoglycemia. 

Korytkowski M, et al. Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2022;107(8):2101-2128.  

In a retrospective claims analysis from Kaiser Permanente of Northern California, 149 patients with insulin-treated type 2 diabetes (T2D; baseline HbA1c <8%) who initiated real-time continuous glucose monitoring (RT-CGM) demonstrated durable glycemic benefit compared with 17,273 noninitiators serving as reference. RT-CGM initiation was associated with decreased HbA1c (-0.06%) while noninitiation was associated with increased HbA1c (+0.32%). A weighted adjusted difference-in-difference model of change in HbA1c yielded a net benefit of -0.30% (P=0.004) for RT-CGM. These findings highlight the notion that RT-CGM may be useful in preventing glycemic deterioration and offer a durable benefit in well-controlled patients with insulin-treated T2D.

Karter AJ, Parker MM, Moffet HH, Gilliam LK, Dlott R. Continuous Glucose Monitor Use Prevents Glycemic Deterioration in Insulin-Treated Patients with Type 2 Diabetes. Diabetes Technol Ther. 2022;24(5):332-337.