Results from a randomized trial of intensive glucose management using CGM versus usual care in hospitalized adults with type 2 diabetes: the TIGHT study
Open accessAbstract
Objective To evaluate whether continuous glucose monitoring (CGM) could assist providers in intensifying glycemic management in hospitalized patients with type 2 diabetes. Research design and methods At six academic hospitals, adults with type 2 diabetes hospitalized in a non-intensive care setting were randomly assigned to either standard therapy with glucose target 140-180 mg/dL (standard group) or intensive therapy with glucose target 90-130 mg/dL guided by CGM (intensive group). The primary outcome was mean glucose measured with CGM (blinded in standard group), and the key secondary outcome was CGM glucose Results For the 110 participants included in the primary analysis, mean ± SD age was 61 ± 12 years and mean HbA1c was 8.9 ± 2.3% (73.8 ± 1.6 mmol/mol). During the study, CGM-measured mean glucose was 170 mg/dL for the intensive group (n = 60) vs. 175 mg/dL for the standard group (n = 50; risk-adjusted difference -7 mg/dL, 95% CI -19 to 5; P = 0.25). Only 7% of the intensive group achieved the mean glucose target range of 90-130 mg/dL. CGM readings Conclusions The study's glucose management approach using CGM did not improve glucose levels compared with standard glucose management in the non-intensive care unit hospital setting. A glucose target of 90-130 mg/dL may not be realistic in the current environment of insulin management in the hospital.
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A recent multicenter randomized clinical trial did not show a benefit of using CGM over POC monitoring for insulin adjustment in individuals with type 2 diabetes hospitalized for noncritical illness.
“However, a recent multicenter randomized clinical trial did not show a benefit of using CGM over POC monitoring for insulin adjustment in individuals with type 2 diabetes hospitalized for noncritical illness (53).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [53]
Both groups in that trial achieved similar mean blood glucose levels (170 ± 32 vs. 175 ± 33 [P = 0.25]) with similarly low levels of hypoglycemia.
“Both groups achieved similar mean blood glucose levels (170 ± 32 vs. 175 ± 33 [P = 0.25]) with similarly low levels of hypoglycemia.”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [53]
Cites
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Self-citationDavis, 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-citationLee, M. Y., Seav, S. M., Ongwela, L., Lee, J. J., Aubyrn, R., Cao, F. Y., Kalinsky, A., Aparicio Ramos, O., Gu, Y., Kingston, K., et al. (2024) · Diabetes Care · doi:10.2337/dc24-0626 · Cited by 32 · see citing works
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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
- Authors
- Hirsch, I. B., Draznin, B., Buse, J. B., Raghinaru, D., Spanbauer, C., Umpierrez, G. E., Ullal, J., Jones, M. S., Low Wang, C. C., Spanakis, E. K., Chao, J. H., Sibayan, J., Kollman, C., Zabala, Z. E., Moazzami, B., Reynolds, S. L., Ferrara, W., Fulghum, K., Kass, A., Armstrong, C., Gilani, F., Seggelke, S., Churchill, J., Monye, J. O., Choe, M. Y., Scott, W., Baran, J. D., Bais, R., Khakpour, D., Pasquel, F. J., Davis, G. M., Vellanki, P., Kershaw, E. E., Gligorijevic, N., Goley, A., Garg, A., Alexander, B., Matson, B. C., Diner, J., Klein, K. R., Adair, W. B., Choksi, P., Huang, M., Vinh, J., Singh, L. G., Beck, R. W., TIGHT RCT Study Group, Spanakis, E. K., Choe, M. Y., Monye, J. O., Scott, W., Churchill, J., Singh, L. G., Umpierrez, G. E., Pasquel, F. J., Davis, G. M., Zabala, Z. E., Moazzami, B., Vellanki, P., Low Wang, C. C., Draznin, B., Seggelke, S., Adair, W. B., Choksi, P., Huang, M., Vinh, J., Graham, P., Jones, M. S., Fulghum, K., Buse, J. B., Donahue, C., Kass, A., Matson, B. C., Ravulapally, S., Armstrong, C., Fraser, R., Alexander, B., Diner, J., Garg, A., Goley, A., Hudson, V., Gilani, F., Klein, K. R., Morba, C., Velez, C., Te Vazquez, J., Ullal, J., Kershaw, E. E., Gligorijevic, N., Reynolds, S. L., Ferrara, W., Henry, A., Rial, E., Chao, J. H., Bais, R., Khakpour, D., Baran, J., Hirsch, I. B., Beck, R., Sibayan, J., Davis, J., Kollman, C., Raghinaru, D., Spanbauer, C., McNabb, D., Guzzetta, R., Ubas, C., Lingvay, I., Weinstock, R., & McGill, J.
- Affiliations
- University of Washington (US)
- 4Jaeb Center for Health Research, Tampa, FL
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2024-11-21
- Volume
- 48
- Issue
- 1
- Pages
- 118-124
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC12328254
- OpenAlex
- W4404582813
- Cited by
- 26
- References
- 4
- Citations by year
- 2026: 11 · 2025: 15
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dexcom Inc
- Topics
- 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 Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- continuous glucose monitoring, tight glycemic control, type 2 diabetes, hospitalized patients, hypoglycemia, insulin management, mean blood glucose
- MeSH terms
- Glycemic Control, Aged, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Hospitalization, Humans, Hypoglycemic Agents, Male, Middle Aged, Blood Glucose Self-Monitoring
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