Inpatient Continuous Glucose Monitor Alerts Show Mixed Results in Trial

Continuous glucose monitoring (CGM) alerts in hospitalized diabetes patients showed limited benefit, according to a recent trial. Researchers found that turning on threshold alerts in the CGM system led to a modest improvement in average time spent within the target glucose range (TIR) of 70-180 mg/dL. However, adding predictive alerts did not provide additional advantages.

A team led by Dr. Jian Zhou from Shanghai Jiao Tong University School of Medicine in China published their findings in JAMA Network Open. The authors noted that a 3% change in mean TIR is considered clinically meaningful in clinical trials, and the observed 3.9% improvement in the threshold-only group may represent a meaningful change in glucose control.

While the threshold-only alerts showed promise, the study suggests that integrating predictive alerts may not further enhance inpatient glucose management. Factors such as exogenous insulin administration, staffing limitations, and alarm fatigue could explain why combining both alert types did not yield better results. The researchers emphasize the need for further studies to evaluate how well CGM alerts are implemented in clinical settings, as the effectiveness of alarms depends not only on the technology but also on the clinical systems that deliver, interpret, and act upon them.