JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Evaluation of a Continuous Glucose Monitoring-Based Insulin Titration Protocol for Inpatients With Type 2 Diabetes in Nonintensive Care Unit Settings

  • 0Steno Diabetes Center Copenhagen, Herlev-Gentofte Hospital, Copenhagen University Hospital, Hilleroed, Denmark.
Journal of Diabetes Science and Technology +

|

April 5, 2025

|

April 5, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A continuous glucose monitoring (CGM)-based insulin titration protocol was successfully implemented in non-intensive care units. The protocol showed high adherence and usability, offering a framework for inpatient diabetes management.

Area Of Science

  • Endocrinology
  • Diabetes Management
  • Medical Informatics

Background

  • Lack of a standardized continuous glucose monitoring (CGM)-based insulin titration protocol hinders inpatient glycemic control.
  • This study assesses the Olsen et al. protocol's acceptability and operability in non-intensive care unit (non-ICU) settings for type 2 diabetes patients.

Purpose Of The Study

  • To evaluate the feasibility and acceptance of a specific CGM-based insulin titration protocol for hospitalized patients with type 2 diabetes outside of intensive care.
  • To determine the adherence rates and usability of the protocol among inpatient diabetes teams.

Main Methods

  • Seven members of an inpatient diabetes team managed insulin adjustments for 84 patients over 353 days.
  • Teams could follow or override the CGM-based protocol for basal, prandial, and correctional insulin, with usability assessed via questionnaires.

Main Results

  • High adherence to the protocol was observed: 96.3% for basal insulin, and 83.9%-92.6% for prandial insulin across meals.
  • All correctional insulin titrations followed the protocol. Team members rated protocol usability highly (mean scores 7.4-8.7 out of 10).

Conclusions

  • The CGM-based insulin titration protocol by Olsen et al. is effectively implementable in non-ICU settings for type 2 diabetes inpatients.
  • The protocol demonstrates high acceptance and usability among healthcare teams, providing a viable framework for inpatient CGM integration.

Keywords:

Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects 01:16

129

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

Diabetes: Management and Pharmacotherapy 01:15

214

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

Diabetes Mellitus: Type 2 and Gestational 01:22

2.1K

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

Insulin Formulations: Types and Delivery 01:27

143

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...

Diabetes Mellitus: Overview and Type I Subtype 01:22

2.3K

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...

Hypoglycemia and Glucagon 01:15

143

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...