Diabetes technology arrives in hospital on the patient, and most wards have had no agreed answer to what happens next. An international position statement covering non-critically ill hospitalised adults sets out practical approaches for continuous glucose monitoring, insulin pumps and automated insulin delivery systems. It addresses selection criteria for who is managed on technology in hospital, CGM-derived glycaemic metrics and targets for inpatients, insulin titration and administration, perioperative care, alarm settings for hypoglycaemia and hyperglycaemia, staff training and workflow, integration of device data with the electronic health record, what to do around imaging, and discharge planning.
That list is the point. The usual failure is not a clinical disagreement about targets — it is that nobody on the ward at 2 a.m. knows whether the pump comes off before a CT scan, who is allowed to change a basal rate, or whether the CGM reading on the patient's phone can be acted on. A position statement that names alarm thresholds, workflow and imaging is addressing the operational gaps rather than restating glycaemic goals.
For an Indian hospital the constraint is usually staff familiarity rather than device availability, and the training and workflow sections are the ones to read first. Use it to write a local policy: which patients keep their device, who is competent to adjust it, what the ward does when the sensor alarms, and what happens at discharge. The document asks to be adapted, and a ward without a written answer defaults to removing the device, which is the worse option for most patients.
- Write a local policy on who keeps their pump or CGM in hospital, and who on the ward may adjust it.
- Agree explicit alarm thresholds for the ward and who responds to them.
- Set a rule for imaging — whether the device comes off for CT, MRI or X-ray — before it is needed at night.
- Decide whether ward staff may act on CGM values or must confirm with capillary glucose, and document it.
- Put device supplies and a follow-up plan into the discharge checklist; this is where continuity is lost.
Why it matters
The device on the patient's arm is currently governed by whoever is on the ward that night.
Don't overread it
This is expert consensus for non-critically ill adults; it does not extend to critical care and it is not trial evidence of better outcomes.
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