Inpatient glucose management is challenging given the complexities of care for hospitalized patients with diabetes. Glucose variability and hypoglycemia have been associated with worse outcomes in hospitalized patients. Some of the challenges to address the adoption of CGM in the hospital include: financial, regulatory, clinical goals of implementation, staff training, data collection and display, patient selection, protocol development. Not every hospitalized patient requiring insulin can be monitored using CGM. The DTS’s consensus guideline emphasize the need for hospitals to develop policies, processes, staff education and recommendations for initiating CGM in the hospital. We study a Clinical Case. A.L. is 37-year-old woman diagnosed as having diabetes at age 29, treated with Degludec 20UI bed time, Aspat10UI lunch and 10 UI dinner, Dulaglutide 1.5mg/sett. Her coexisting medical conditions: renal transplant at age12, repeated at 28, obesity and recent amenorrhea. Diabetes was in poor glycemic control due to anxiety related previous hypoglycemic events (Hb A1C 12%). Non alteration of kidney functional test. From 4 month she have fever. Pneumonia covid negative was diagnosed, and start treatment with penicillin and corticosteroides, with worsening of blood sugar levels. At TC was found persistent pulmonary consolidations, so she was admitted in Internal Medicine Unit to make more specific diagnosis examination (as bronchoscopy) and treatment. We decide apply glycemic sensor FreeStyleLibre2 with the purpose to optimize the glycemic control during the hospitalization. We detected very high glucose level, corrected with adjustment insulin dose, and extra corrective bolus (Fig. 1. ReportCGM). The patient were able to detect lowering of glycemic value and prevent hypoglycemic event. Sometimes were necessary a glucose capillar test for confirmation of value. We noted a reduction of patient’s anxiety, more confidential to insulin therapy. CGM is a technology that must be embraced in the inpatient setting. Much work are needed to correct evaluation and implementation.
