Inpatient diabetes management is challenging due to acute illness, variable insulin requirements, and reliance on intermittent point-of-care glucose testing. Both hyperglycemia and hypoglycemia are associated with increased costs, length of stay, morbidity, and mortality. However, efforts to achieve tighter glycemic targets are often limited by the risk of iatrogenic hypoglycemia. Notably, hypoglycemia (glucose 80% with type 2 diabetes]) and three RCTs from the ICU setting ( N = 142 with and without preexisting diabetes) were identified. Meta-analysis of RCTs in the non-ICU setting showed that AID increased TIR by 24.6 percentage points (95% confidence interval 20.7–28.5). A meta-analysis on ICU data could not be conducted. Across all settings, AID was associated with reduced hyperglycemia without an increase in hypoglycemia. Clinical outcomes were sparsely reported. AID systems can be safely and effectively used in non-ICU hospital settings to improve glycemic outcomes. Larger, multicenter trials are needed to confirm clinical benefits and address implementation challenges.
Olsen et al. (Wed,) studied this question.
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