An international group of inpatient diabetes specialists has published a position statement on using continuous glucose monitoring (CGM), insulin pumps and automated insulin delivery (AID) systems in non-critically ill adults admitted to hospital. It is expert consensus, not a trial.
It covers the questions wards meet every week: which patients are suitable to stay on their own device, which CGM-derived glucose targets to use, how insulin is titrated and given, what happens around surgery, how to set hypoglycaemia and hyperglycaemia alarms, staff training and workflows, getting device data into the electronic record, imaging, and discharge planning.
The practical message is that a device-wearing patient needs a plan agreed at admission rather than a default of removing everything. Wards that admit people on pumps or AID should have a written local pathway covering who checks the device, when it comes off, and how glucose is confirmed while it is off.
- At admission, record the device type, current settings and who in the team is responsible for checking it.
- Decide early whether the patient can safely self-manage the device; drowsiness, confusion or critical illness are reasons to switch to staff-led insulin.
- Check the device manufacturer's guidance before MRI, CT or diathermy, and have a plan for glucose monitoring while it is removed.
- Confirm suspicious CGM readings with a capillary glucose before acting on them.
- Start discharge planning, including supplies and follow-up, before the day of discharge.
Why it matters
More inpatients now arrive wearing these devices than most ward protocols were written for.
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