Efficacy of Continuous Glucose Monitoring in Guiding Inpatient Insulin Therapy

What is it about?

This randomized controlled trial evaluated the efficacy and safety of real-time continuous glucose monitoring (CGM) in adjusting inpatient insulin therapy. The study included 185 patients with type 1 and type 2 diabetes treated with a basal-bolus insulin regimen. The primary endpoints were differences in time in range (TIR), hypoglycemia, and mean daily glucose. The results showed no significant differences in TIR, mean daily glucose, or percent of patients with CGM values <70 mg/dL or <54 mg/dL between the CGM-guided and point-of-care (POC) groups. However, among patients with one or more hypoglycemic events, the CGM group experienced a significant reduction in hypoglycemia reoccurrence, lower percentage of time below range <70 mg/dL, and a lower incidence rate ratio <70 mg/dL and <54 mg/dL. The study suggests that real-time Dexcom G6 CGM is safe and effective in guiding insulin therapy, resulting in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemic events compared with POC-guided insulin adjustment.

Featured Image

Why is it important?

This research is important because it evaluates the efficacy and safety of using real-time continuous glucose monitoring (CGM) in adjusting inpatient insulin therapy. Diabetes is a common condition in hospitalized patients, and dysglycemia (hyperglycemia, hypoglycemia, and increased glucose variability) has been associated with adverse outcomes such as prolonged length of stay and increased risk of complications. Therefore, optimizing glycemic control in hospitalized patients with diabetes is essential for improving patient outcomes and reducing healthcare costs. This study found that the use of real-time Dexcom G6 CGM is safe and effective in guiding insulin therapy, resulting in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemic events compared with the standard of care (point-of-care or POC) testing. These findings indicate that the use of real-time CGM can improve glycemic control and reduce the risk of hypoglycemia in hospitalized patients with diabetes, which can lead to better patient outcomes and reduced healthcare costs. Key Takeaways: 1. The use of real-time continuous glucose monitoring (CGM) is safe and effective in guiding inpatient insulin therapy. 2. Real-time CGM resulted in a similar improvement in glycemic control and time in range compared with point-of-care (POC) testing. 3. The use of real-time CGM resulted in a significant reduction of recurrent hypoglycemic events compared with POC testing. 4. The reduction in recurrent hypoglycemic events was seen overnight, a time that POC is rarely checked. 5. Real-time CGM can improve glycemic control and reduce the risk of hypoglycemia in hospitalized patients with diabetes, which can lead to better patient outcomes and reduced healthcare costs.