Diabetes Technology in the Inpatient Setting for Management of Hyperglycemia

Abstract

In past decades, a rapid evolution of diabetes technology led to increased popularity and use of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) in the ambulatory setting for diabetes management, and recently, the artificial pancreas became available. Efforts to translate this technology to the hospital setting have shown accuracy and reliability of CGM, safety of CSII in appropriate populations, improvement of inpatient glycemic control with computerized glycemic management systems, and feasibility of inpatient CGM-CSII closed-loop systems. Several ongoing studies are focusing on continued translation of this technology to improve glycemic control and outcomes in hospitalized patients.

Keywords: Diabetes; Glycemic control; Hospital; Inpatient; Technology.

Conflict of interest statement

Disclosure G.M. Davis and A.L. Migdal have no disclosures. R.J. Galindo is partly supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number P30DK11102. R.J. Galindo has received research grant support to Emory University for investigator-initiated studies from Novo Nordisk, and consulting fees from Abbott Diabetes Care, Sanofi, Valeritas, and Novo Nordisk. G.E. Umpierrez is partly supported by research grants from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378 from the Clinical and Translational Science Award program and a National Institutes of Health (NIH) grant U30, P30DK11102, and has received research grant support to Emory University for investigator-initiated studies from Sanofi, Novo Nordisk, and Dexcom.

Copyright © 2019 Elsevier Inc. All rights reserved.

Figures

Fig. 1.

Algorithm for inpatient continuation of CSII-CGM therapy hospitalization. EGD, upper endoscopy; IV, intravenous. (From Umpierrez GE, Klonoff DC. Diabetes Technology Update: Use of Insulin Pumps and Continuous Glucose Monitoring in the Hospital. Diabetes Care. 2018;41(8):1579–1589; with permission.)