Continuous Glucose Monitoring in Hospitalized Patients with Type 2 Diabetes: A Step Forward in Inpatient Glycemic Control.

Abstract

Objectives: To determine the effect and safety of Continuous Glucose Monitoring (CGM) use in glycemic control compared to standard approach in hospitalized patients with Type 2 Diabetes (T2D).

Methods: This was a pilot randomized controlled clinical trial enrolled 37 hospitalized patients with T2D admitted in medical and surgical wards. All patients used CGM (Abbott FreeStyle2 or FreeStyle3) and concomitantly 6-point point of care glucose (POCG). In group A (n=19), daily CGM profiles, alarms, and trend arrows were considered for glycemic therapeutic decisions and in group B (n=18) were based on POCG. Primary outcomes included the difference in time in range (TIR) 70-180 mg/dL, hospital glycemia risk index (GRI), time below range (TBR) measured as the percentage below 70 mg/dL and below 54 mg/dL, and time above range (TAR) measured as the percentage above 180 mg/dL and above 250 mg/dL.

Results: TIR was higher in group A: 78.26±10.83% vs. 67.39±19.13% p=0.04. TAR level 1 in group A: 14.37±8.33% vs. group B: 23.28±16.62% p=0.04. Asymptomatic hypoglycemic events were more detected by CGM-group (1.65±2.03 vs. 0.31±0.60 p=0.01). Overall MARD: 14.7%. DTS Error Grid: 69.5% zone A and 29.3% zone B.

Conclusions: The implementation of CGM in hospitals could represent a significant advancement in diabetes management, offering a more comprehensive and dynamic approach to monitoring glucose levels. Further research is needed to explore the long-term impacts of CGM on clinical outcomes and to optimize its integration into hospital protocols.