Continuous glucose monitoring in inpatient care (general/critical care)

Abstract

To evaluate the scientific evidence published between 2020 and 2026 regarding the clinical effectiveness, analytical precision, reduction of nursing care burden and economic profitability of continuous glucose monitoring (CGM) in adult patients hospitalized in both Intensive Care Units (ICU) and general wards.

Consolidated meta-analyses and systematic reviews demonstrate superiority of CGM over point-of-care (POC) capillary monitoring. In non-critical rooms, CGM significantly increases Time in Range (IRR 70–180 mg/dL), achieving parallel reductions in hyperglycemia (>180 mg/dL) and time in hypoglycemia (<70 mg/dL). In the ICU, CGM reduces the incidence of hypoglycemic events and is associated with lower in-hospital mortality. Analytically, subcutaneous biosensors demonstrate remarkable resilience in states of peripheral vasoconstriction due to inotropes, septic shock, cardiovascular postoperative and diabetic ketoacidosis, preserving a Mean Absolute Relative Difference (MARD) of 11% to 13% and more than 98% of glycemic pairs in Clarke and Parkes zones A+B. However, the alert is emphasized on spurious electrochemical interference induced by hydroxyurea (MARD up to 91%), requiring confirmatory POC controls. Operationally, the telematic transition reduces nursing time per measurement from 5 minutes to 3 seconds, alleviating the Fear of Hypoglycemia. In pharmaco-economic terms, the system generates a reduction in costs by preventing complications).

In conclusion, CGM redefines hospital metabolic safety. The 2024–2026 ADA guidelines legitimize the hybrid model, the preservation of technology at admission, and standardized structured discharge schemes.