Continuous glucose monitoring-guided insulin administration in hospitalized patients with diabetes: a randomized clinical trial
Open accessAbstract
OBJECTIVE: The efficacy and safety of continuous glucose monitoring (CGM) in adjusting inpatient insulin therapy have not been evaluated. RESEARCH DESIGN AND METHODS: This randomized trial included 185 general medicine and surgery patients with type 1 and type 2 diabetes treated with a basal-bolus insulin regimen. All subjects underwent point-of-care (POC) capillary glucose testing before meals and bedtime. Patients in the standard of care (POC group) wore a blinded Dexcom G6 CGM with insulin dose adjusted based on POC results, while in the CGM group, insulin adjustment was based on daily CGM profile. Primary end points were differences in time in range (TIR; 70–180 mg/dL) and hypoglycemia (<70 mg/dL and <54 mg/dL). RESULTS: There were no significant differences in TIR (54.51% ± 27.72 vs. 48.64% ± 24.25; P = 0.14), mean daily glucose (183.2 ± 40 vs. 186.8 ± 39 mg/dL; P = 0.36), or percent of patients with CGM values <70 mg/dL (36% vs. 39%; P = 0.68) or <54 mg/dL (14 vs. 24%; P = 0.12) between the CGM-guided and POC groups. Among patients with one or more hypoglycemic events, compared with POC, the CGM group experienced a significant reduction in hypoglycemia reoccurrence (1.80 ± 1.54 vs. 2.94 ± 2.76 events/patient; P = 0.03), lower percentage of time below range <70 mg/dL (1.89% ± 3.27 vs. 5.47% ± 8.49; P = 0.02), and lower incidence rate ratio <70 mg/dL (0.53 [95% CI 0.31–0.92]) and <54 mg/dL (0.37 [95% CI 0.17–0.83]). CONCLUSIONS: The inpatient use of real-time Dexcom G6 CGM is safe and effective in guiding insulin therapy, resulting in a similar improvement in glycemic control and a significant reduction of recurrent hypoglycemic events compared with POC-guided insulin adjustment.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Data on the safety and efficacy of real-time CGM use in the hospital, particularly with implementation of remote monitoring (e.g., a glucose telemetry system), has grown.
“Data on the safety and efficacy of real-time CGM use in the hospital, particularly with implementation of remote monitoring (e.g., a glucose telemetry system), has grown (47,50-52).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [47]
Studies assessing effectiveness of inpatient CGM may ultimately lead to approved use of CGM for monitoring hospitalized individuals.
“Studies have been published assessing the effectiveness of this approach, which may ultimately lead to the approved use of CGM for monitoring hospitalized individuals (277,286-295).”
From 7. Diabetes Technology: Standards of Care in Diabetes—2025 (2025) · cites this paper as [293]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., Bosi, E., Buckingham, B. A., Cefalu, W. T., Close, K. L., et al. (2019) · Diabetes Care · doi:10.2337/dci19-0028 · Cited by 4,032 · see citing works
Standards of Medical Care in Diabetes—2012
(2012) · Diabetes Care · doi:10.2337/dc12-s011 · Cited by 2,240 · see citing works
Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes
Umpierrez, G. E., Isaacs, S. D., Bazargan, N., You, X., Thaler, L. M., & Kitabchi, A. E. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.3.8341 · Cited by 2,195 · see citing works
Self-citationMoghissi, E. S., Korytkowski, M. T., DiNardo, M., Einhorn, D., Hellman, R., Hirsch, I. B., Inzucchi, S. E., Ismail-Beigi, F., Kirkman, M. S., & Umpierrez, G. E. (2009) · Diabetes Care · doi:10.2337/dc09-9029 · Cited by 1,444 · see citing works
Self-citationFurnary, A. P., Gao, G., Grunkemeier, G. L., Wu, Y., Zerr, K. J., Bookin, S. O., Floten, H. S., & Starr, A. (2003) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1067/mtc.2003.181 · Cited by 1,130 · see citing works
Umpierrez, G. E., Hellman, R., Korytkowski, M. T., Kosiborod, M., Maynard, G. A., Montori, V. M., Seley, J. J., & Van den Berghe, G. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2098 · Cited by 1,126 · see citing works
Self-citationUmpierrez, G. E., Smiley, D., Jacobs, S., Peng, L., Temponi, A., Mulligan, P., Umpierrez, D., Newton, C., Olson, D., & Rizzo, M. (2011) · Diabetes Care · doi:10.2337/dc10-1407 · Cited by 720 · see citing works
Self-citationUmpierrez, G. E., Smiley, D., Zisman, A., Prieto, L. M., Palacio, A., Ceron, M., Puig, A., & Mejia, R. (2007) · Diabetes Care · doi:10.2337/dc07-0295 · Cited by 671 · see citing works
Self-citationKosiborod, M. (2009) · JAMA · doi:10.1001/jama.2009.496 · Cited by 363 · see citing works
Management of diabetes and hyperglycaemia in the hospital
Pasquel, F. J., Lansang, M. C., Dhatariya, K., & Umpierrez, G. E. (2021) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30381-8 · Cited by 329 · see citing works
Self-citationMendez, C. E., Mok, K.-T., Ata, A., Tanenberg, R. J., Calles-Escandón, J., & Umpierrez, G. E. (2013) · Diabetes Care · doi:10.2337/dc12-2430 · Cited by 211 · see citing works
Self-citation14. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes—2018
American Diabetes Association (2017) · Diabetes Care · doi:10.2337/dc18-s014 · Cited by 182 · see citing works
Galindo, R. J., Migdal, A. L., Davis, G. M., Urrutia, M. A., Albury, B., Zambrano, C., Vellanki, P., Pasquel, F. J., Fayfman, M., Peng, L., et al. (2020) · Diabetes Care · doi:10.2337/dc19-2073 · Cited by 181 · see citing works
Self-citationUmpierrez, G. E., Hor, T., Smiley, D. D., Temponi, Á., Umpierrez, D., Cerón, M., Munoz, C., Newton, C. A., Peng, L., & Baldwin, D. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1441 · Cited by 180 · see citing works
Self-citationHypoglycemia-associated mortality is not drug-associated but linked to comorbidities
Boucai, L., Southern, W. N., & Zonszein, J. (2011) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.07.011 · Cited by 175 · see citing works
Continuous glucose monitors and automated insulin dosing systems in the hospital consensus guideline
Galindo, R. J., Umpierrez, G. E., Rushakoff, R. J., Basu, A., Lohnes, S., Nichols, J. H., Spanakis, E. K., Espinoza, J., Palermo, N. E., Awadjie, D. G., et al. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820954163 · Cited by 170 · see citing works
Self-citationDavis, G. M., Spanakis, E. K., Migdal, A. L., Singh, L. G., Albury, B., Urrutia, M. A., Zamudio-Coronado, K. W., Scott, W. H., Doerfler, R., Lizama, S., et al. (2021) · Diabetes Care · doi:10.2337/dc20-2856 · Cited by 160 · see citing works
Self-citationSingh, L. G., Satyarengga, M., Marcano, I., Scott, W. H., Pinault, L. F., Feng, Z., Sorkin, J. D., Umpierrez, G. E., & Spanakis, E. K. (2020) · Diabetes Care · doi:10.2337/dc20-0840 · Cited by 154 · see citing works
Self-citationConsensus Statement on Inpatient Use of Continuous Glucose Monitoring
Wallia, A., Umpierrez, G. E., Rushakoff, R. J., Klonoff, D. C., Rubin, D. J., Golden, S. H., Cook, C. B., & Thompson, B. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817706151 · Cited by 147 · see citing works
Self-citationContinuous glucose monitoring in the intensive care unit during the COVID-19 pandemic
Agarwal, S., Mathew, J., Davis, G. M., Shephardson, A., Levine, A., Louard, R., Urrutia, A., Perez-Guzman, C., Umpierrez, G. E., Peng, L., et al. (2021) · Diabetes Care · doi:10.2337/dc20-2219 · Cited by 138 · see citing works
Self-citationFortmann, A., Bagsic, S. R. S., Talavera, L., Garcia, I. M., Sandoval, H., Hottinger, A., & Philis-Tsimikas, A. (2020) · Diabetes Care · doi:10.2337/dc20-1016 · Cited by 107 · see citing works
Burt, M. G., Roberts, G. W., Aguilar-Loza, N. R., & Stranks, S. N. (2013) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2012.0282 · Cited by 83 · see citing works
Farrokhi, F., Klindukhova, O., Chandra, P., Peng, L., Smiley, D. D., Newton, C. A., Pasquel, F. J., Fereira, M. E., & Umpierrez, G. E. (2012) · Journal of Diabetes Science and Technology · doi:10.1177/193229681200600505 · Cited by 73 · see citing works
Self-citationSpanakis, E. K., Levitt, D. L., Siddiqui, T., Singh, L. G., Pinault, L. F., Sorkin, J. D., Umpierrez, G. E., & Fink, J. C. (2017) · Journal of Diabetes Science and Technology · doi:10.1177/1932296817748964 · Cited by 68 · see citing works
Self-citationContinuous glucose monitoring in the hospital: an update in the era of COVID-19
Gothong, C., Singh, L. G., Satyarengga, M., & Spanakis, E. K. (2021) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000693 · Cited by 58 · see citing works
Self-citationContinuous Glucose Monitoring in Insulin-Treated Patients in Non-ICU Settings
Gómez, A. M., & Umpierrez, G. E. (2014) · Journal of Diabetes Science and Technology · doi:10.1177/1932296814546025 · Cited by 51 · see citing works
Self-citationChow, K. W., Kelly, D. J., Rieff, M. C., Skala, P. A., Kravets, I., Charitou, M. M., Morley, E. J., Gupta, R., & Miller, J. D. (2021) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820985263 · Cited by 40 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
7. Diabetes Technology: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s007 · Cited by 348 · see citing works
7. Diabetes Technology: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s007 · Cited by 281 · see citing works
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
Uhl, S., Choure, A., Rouse, B., Loblack, A., & Reaven, P. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad652 · Cited by 76 · see citing works
Digital Technology for Diabetes
Hughes, M. S., Addala, A., & Buckingham, B. (2023) · New England Journal of Medicine · doi:10.1056/nejmra2215899 · Cited by 59 · see citing works
Davis, G. M., Hughes, M. S., Brown, S. A., Sibayan, J., Perez-Guzman, M. C., Stumpf, M., Thompson, Z., Basina, M., Patel, R. M., Hester, J., et al. (2023) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2023.0304 · Cited by 41 · see citing works
Self-citationIdrees, T., Castro-Revoredo, I. A., Oh, H. D., Gavaller, M. D., Zabala, Z., Moreno, E., Moazzami, B., Galindo, R. J., Vellanki, P., Cabb, E., et al. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.01.031 · Cited by 22 · see citing works
Self-citation
- Authors
- Spanakis, E. K., Urrutia, A., Galindo, R. J., Vellanki, P., Migdal, A. L., Davis, G., Fayfman, M., Idrees, T., Pasquel, F. J., Coronado, W. Z., Albury, B., Moreno, E., Singh, L. G., Marcano, I., Lizama, S., Gothong, C., Munir, K., Chesney, C., Maguire, R., Scott, W. H., Perez-Guzman, M. C., Cardona, S., Peng, L., & Umpierrez, G. E.
- Affiliations
- University of Maryland Medical Center (US)
- Emory University (US)
- 3Emory University School of Medicine, Atlanta, GA
- Baltimore VA Medical Center (US)
- Corresponding author
- Umpierrez, Guillermo E.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2022-08-19
- Volume
- 45
- Issue
- 10
- Pages
- 2369-2375
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC9643134
- OpenAlex
- W4292379787
- Cited by
- 153
- References
- 27
- Citations by year
- 2026: 28 · 2025: 44 · 2024: 56 · 2023: 21 · 2022: 3
- FWCI
- 22.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH/NATS (UL 3UL1TR002378-05S2)
- VA Merit CSRD (1I01CX001825)
- National Institute of Diabetes and Digestive and Kidney Diseases (1K23DK113241, 1K23DK122199, 1K23DK123384-03, K23GM128221, P30DK11102)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- continuous glucose monitoring, insulin dose adjustment, hospitalized patients, type 1 diabetes, type 2 diabetes, multiple daily insulin injections, hypoglycemia, time in range, point-of-care glucose testing, Dexcom G6, inpatient glycemic control
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 2, Glucose, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Blood Glucose Self-Monitoring, Insulin, Regular, Human
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
