Can CGM improve management of patients hospitalized? evaluation from a department case study

Introduction: To compare diabetes metrics in patients hospitalized in internal medicine for acute respiratory or septic event between those who used traditional glycemic monitoring (DTX) or continuous glucose monitoring (CGM). Methods: Retrospective study of a cohort of 180 patients hospitalized between April-December 2023, 90 of whom were monitored using CGM and comparison of their glycemic parameters with other 90 patients with a similar admission diagnosis who were monitored using DTX. In CGM group, we evaluated mean glycemia (MBG), standard deviation (SD) of MBG, glycemic coefficient of variability (CV), time in range (TIR% 70-180 mg%), time above range (TAR% >180 mg%), and time below range (TBR% <70 mg%). In DTX group, we evaluated MBG as the mean of daily glycemic values (on average 4.5 DTX samples/day), CV as SD/MBG, TIR as% of DTX values between 70-180 mg%, TAR as% of DTX >180 mg%, and TBR as a% of DTX<70 mg%. An additional analysis was conducted on a subgroup of 16 patients, comparing their metrics before and after transitioning from DTX to CGM to further understand the impact of CGM on glycemic control within the same individuals. Results: Levene’s test suggested homogeneity of variances for most of the metrics, with p-values >0.05, indicative of no significant variability discrepancy, except for TBR. T-test unveiled substantial disparities between the groups: MBG demonstrated a significant mean difference (p<0.05), underscoring a substantial divergence in average blood glucose levels. Other parameters, including CV, TIR, and TAR, also manifested statistically significant differences. The subgroup analysis of 16 patients revealed a decrease in mean glycemia from 206.87 to 177.00 mg/dL (14.44% reduction), a decrease in SD from 63.13 to 47.69 mg/dL (24.47% reduction), a decrease in CV from 31.10% to 26.87% (13.61% reduction), an increase in TIR from 38.54% to 56.31% (46.12% increase), a decrease in TAR from 57.24% to 43.38% (24.22% reduction), and a drastic decrease in TBR from 4.22% to 0.31% (92.59% reduction), highlighting significant improvements in glycemic control with the use of CGM. Conclusion: Our experience highlights a significant difference of glycemic metrics between CGM and DTX patients, with the former improving TIR, TBR, and CV. The additional analysis of a subgroup of patients compared with themselves before and after transitioning to CGM further emphasizes the benefits of CGM in acute setting.