"Mellitus Metrics"-Systematic Review of Glucometric Reporting within Hospital-Based Diabetes Studies (2006-2023)

Suboptimal inpatient glycemia is associated with adverse outcomes, including infection, length of stay, and hospitalization costs. Interventions to improve inpatient glycemia may benefit from standardization of in-hospital glycemic measurement and reporting."Glucometrics," as coined by Goldberg et al (2006), proposes models and metrics that allow quantitative inpatient glycemic data analysis. This systematic review investigates the actual use of "glucometric" terminology and its derivations since conception.

Original research articles on "glucometrics" and its derivations in inpatient contexts, published between 2006 and 2023, were searched in five databases. Studies were screened and extracted through PRISMA-compliant review software (Covidence®) and systematically reviewed.

Of 767 studies identified, 44 were included for final review. Study settings included non-critical care wards (n=19), critical care (n=6), and both (n=13). Of the Goldberg models, "patient-day" was most used (n=33). Most studies (n=30) referred to "glucometrics" per the original description. An increase in the introduction of new metrics (e.g., time-weighted averages, adverse glycemic days, and glucose excursions) was seen over the study period, as well as an increase in the use of "glucometric" to refer to glycemic measurement/reporting in general.Significant variation in thresholds defining hyperglycemia/hypoglycemia existed between studies, where hyperglycemia ranged between 140 and 432 mg/dL (most commonly 300 mg/dL), while the hypoglycemia ranged between 40 and 70 mg/dL (most commonly 70 mg/dL).

This systematic review provides insights into contemporary use of glucometric terminology, highlighting the lack of consensus on a standardized approach toward analyzing inpatient glycemia, and the need for glucometric harmonization to improve inpatient glycemia and diabetes care.