An international position statement on practical approaches for inpatient continuous glucose monitoring, insulin pumps and automated insulin delivery systems in adults
Abstract
There is an urgent and unmet need for a practical clinical guideline addressing the use of continuous glucose monitoring (CGM), insulin pumps and automated insulin delivery (AID) systems in hospital settings. The goal with this position statement is to facilitate effective and safe use of these devices to improve glycaemic management, enhance outcomes and contribute to standardisation efforts in initiating or continuing the use of these devices in hospitals for non-critically ill hospitalised adults. The topics covered include selection criteria for management with diabetes technologies, CGM-derived glycaemic metrics and goals for adults with diabetes, insulin titration and administration guidelines, perioperative care, CGM alarm settings for hypoglycaemia and hyperglycaemia, clinical staff training and workflows, integration of device data with the electronic health record, imaging tests considerations and discharge planning.
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Authors: Mikkel Thor Olsen, Elias K. Spanakis, Hood Thabit, Ketan Dhatariya, Omar G. Mustafa, Parizad Avari, Alistair N. Lumb, Kathleen Marie Dungan, Athena Philis‐Tsimikas, Kristen M. Kulasa, David Norman O'Neal, Shashank Joshi, Alexandros Leonidas Liarakos, Emma G. Wilmot, Julie M. Shaw, Roman Vangoitsenhoven, Chantal Mathieu, Irl B. Hirsch, Priyathama Vellanki, Francisco J. Pasquel, Guillermo E. Umpierrez, Rodolfo Javier Galindo, Ulrik Pedersen‐Bjergaard, Peter Lommer Kristensen, Julia Katharina Mader, Kirsten Nørgaard
Institutions: University of Washington, University of Maryland, Baltimore, University of California San Diego, Imperial College London, The University of Melbourne, The Ohio State University Wexner Medical Center, KU Leuven, National Institute for Health and Care Research, University of Manchester, University of Nottingham, Emory University, University of Copenhagen, University of Miami, Copenhagen University Hospital, Imperial College Healthcare NHS Trust, Medical University of Graz, University of East Anglia, St Vincent's Hospital Melbourne, King's College Hospital, Zealand University Hospital, Steno Diabetes Centers, University Hospitals of Derby and Burton NHS Foundation Trust, Manchester Royal Infirmary, Churchill Hospital, Oxford Centre for Diabetes, Endocrinology and Metabolism, Norfolk and Norwich University Hospitals NHS Foundation Trust, Royal Derby Hospital, Steno Diabetes Center Copenhagen, Baltimore VA Medical Center, Scripps Whittier Diabetes Institute, Lilavati Hospital & Research Centre, Canadian Electricity Association