1906-P: Perioperative Use of Diabetes Technology

Introduction and Objective: Automated insulin delivery (AID) systems and continuous glucose monitoring (CGM) have transformed outpatient diabetes care; however, perioperative use remains inconsistently implemented. This study aimed to characterize institutional policies and clinical practice patterns for perioperative diabetes technology use across procedural settings. Methods: Endocrine hospitalists, inpatient endocrinologists, diabetologists, and AACE Diabetes Disease State Network members completed a 28-question survey between August and October 2025. Questions were grouped into four domains: preoperative, same-day procedure, intraoperative, and postoperative settings. Responses were classified as positive (institution permits use or has a defined policy/workflow) or negative (no workflow or use not permitted). Domain-level agreement, institutional and question-level variability, and non-parametric comparisons across domains were performed. Results: A 28-question online survey was sent to 364 diabetes and endocrine providers and 176 members of the AACE Diabetes Disease State Network. Thirty-five hospital representatives completed it. Agreement was highest for policy-related practices, indicating clearer institutional direction where formal policies exist. In contrast, substantial variability was observed in clinical workflows, especially in pre-operative and same-day procedure settings. Positive response rates differed significantly across perioperative settings (p< 0.0001), with the operating room showing the most consistency. Institution-level variability was wide, reflecting heterogeneous adoption of perioperative diabetes technology practices across hospitals. Conclusion: Most institutions support perioperative use of diabetes technology, but marked variability exists in clinical workflows. High-consensus areas represent opportunities for standardization, while high-variability practices highlight the need for targeted, evidence-based perioperative guidelines for effective use of diabetes technologies. Disclosure E. Montaser: None. P. Vellanki: Consultant; Ended; Sanofi, RTI International. W.B. Horton: None. L. Presswala: None.