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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Olsen, MT; Liarakos, AL; Wilmot, EG; Dhatariya, K; Thabit, H; Sánchez-García, D; Nørgaard, K; Pedersen-Bjergaard, U; Hansen, KB; Vangoitsenhoven, R; Mathieu, C; Kristensen, PL; Mader, JK.
Implementation strategies for inpatient continuous glucose monitoring-based diabetes management: a systematic review.
J Clin Endocrinol Metab. 2025; Doi: 10.1210/clinem/dgaf074
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Co-Autor*innen der Med Uni Graz
Mader Julia
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Abstract:
INTRODUCTION: Continuous glucose monitoring (CGM) provides real-time glucose data that has revolutionised outpatient diabetes care; however, its impact on inpatient care remains limited, likely due to the lack of standardised CGM-based insulin titration protocols, implementation strategies, and proper familiarity with the technology among others. METHODS: A systematic literature search was conducted on October 15, 2024, using PubMed and Embase, without a restriction on publication date. The search focused on CGM-based insulin titration protocols and related implementation strategies in non-intensive care unit (non-ICU) settings. This systematic review was registered with PROSPERO (RD42024596819). RESULTS: A total of 7,625 references were screened. Nine protocols for inpatient CGM-based insulin titration and related implementation strategies were identified. Six protocols recommended a weight-based basal-bolus insulin regimen. Insulin titration on basal and bolus insulin was mostly done daily based on either clinical discretion or clearly defined insulin titration protocols. All protocols employed a hybrid approach, utilising both CGM and finger prick glucose testing to guide glucose management. Diabetes-trained staff oversaw CGM-based insulin titration and glucose management in five protocols. CGM-alarm settings varied widely, with hyperglycaemic alarm thresholds between >13.9 and >22.2 mmol/l, and hypoglycaemia alarm thresholds between <3.9 and <5.0 mmol/l. CONCLUSION: We observed considerable variation in the detail and clarity provided by the reviewed protocols. This highlights the need for standardised operational protocols for CGM-based insulin titration and related implementation strategies to implement CGM effectively in non-ICU settings.

Find related publications in this database (Keywords)
diabetes
in-hospital
inpatient
dose
continuous glucose monitoring
insulin titration
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