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Updated: Jun 17, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Implementation of Intermittently Scanned Continuous Glucose Monitoring and Changes in Hospitalizations and Health
Pablo Rodríguez de Vera Gómez1,2, Eduardo Mayoral3, Beatriz Rodríguez Jiménez1,2
1Department of Endocrinology and Nutrition, Virgen Macarena University Hospital, Seville, Spain.
Objective:
To assess the effect of a population-wide implementation of intermittently scanned continuous glucose monitoring (isCGM) on hospitalization rates and trends, length of stay, and inpatient health care costs among adults with insulin-treated type 2 diabetes (T2D).
Research Design And Methods:
This population-based, longitudinal, quasi-experimental cohort study included adults with T2D taking multiple daily insulin injections who initiated publicly funded isCGM between April 2022 and December 2023. Hospitalizations for acute diabetes-related complications (diabetic ketoacidosis, hyperglycemic hyperosmolar state, simple hyperglycemia, and hypoglycemia) and cardiovascular complications (myocardial infarction, stroke, and major lower-extremity amputation) were identified using ICD-10 codes. Incidence rates and rate ratios (RRs) were estimated using Poisson models. Interrupted time series analyses were used to estimate counterfactual trends.
Results:
Among 15,413 participants, the mean follow-up was 22.5 ± 4.6 months before and 19.1 ± 4.4 months after isCGM initiation. Mean HbA1c decreased from 8.09 to 7.65% (mean difference -0.44 [95% CI -0.47 to -0.42]). Diabetes-related hospitalization rates decreased from 74.6 to 27.5 per 10,000 person-years (RR 0.37 [95% CI 0.28-0.49]). Cardiovascular hospitalization rates remained stable (228.8 vs. 215.8 per 10,000 person-years; RR 0.94 [0.84-1.06]). Interrupted time series analyses showed a change in cardiovascular admission rates after isCGM initiation relative to the preintervention trend. Median length of stay decreased from 4 (interquartile range 5) to 3 (4) days. Total inpatient costs decreased by $3,806,776.90 (-$955,186.70 per 10,000 person-years).
Conclusions:
In this real-world study, implementation of isCGM among insulin-treated adults with T2D was associated with substantial reductions in acute diabetes-related hospitalizations, shorter hospital stays, lower health care costs, and changes in cardiovascular hospitalization trends.
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