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Implementation Strategies for Inpatient Continuous Glucose Monitoring-based Diabetes Management: A Systematic Review.
Mikkel T Olsen1, Alexandros L Liarakos2,3, Emma G Wilmot2,3
1Department of Endocrinology and Nephrology, Copenhagen University Hospital-North Zealand, 3400 Hilleroed, Denmark.
The Journal of Clinical Endocrinology and Metabolism
|February 7, 2025
Summary
Standardized protocols are needed for continuous glucose monitoring (CGM) in hospitals. This review found significant variation in current inpatient CGM insulin titration methods, hindering effective implementation.
Area of Science:
- Endocrinology
- Diabetes Management
- Medical Technology
Background:
- Continuous glucose monitoring (CGM) has transformed outpatient diabetes care but its inpatient impact is limited.
- Lack of standardized protocols and familiarity hinders inpatient CGM use.
Purpose of the Study:
- To systematically review existing inpatient continuous glucose monitoring (CGM)-based insulin titration protocols.
- To identify implementation strategies for CGM in non-intensive care units (non-ICU).
Main Methods:
- Systematic literature search of PubMed and Embase conducted on October 15, 2024.
- Focused on CGM-based insulin titration protocols and implementation in non-ICU settings.
- Registered with PROSPERO (RD42024596819).
Main Results:
- Nine inpatient CGM-based insulin titration protocols identified from 7,625 references.
- Six protocols recommended weight-based basal-bolus insulin; titration often daily.
- Protocols used hybrid CGM and finger prick testing; alarm settings varied widely.
Conclusions:
- Considerable variation exists in the detail and clarity of reviewed protocols.
- Standardized operational protocols are crucial for effective inpatient CGM implementation.
- Need for clear implementation strategies to optimize CGM use in non-ICU settings.
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