Feasibility of continuous glucose monitoring in an acute geriatric unit - the GLYCOGER study.

BACKGROUND

Continuous glucose monitoring (CGM) enhances glycemic control and reduces hypoglycemia in patients with diabetes, but its use in geriatric inpatients remains limited. AIM: To assess the feasibility in CGM use among patients hospitalized in an acute geriatric unit.

METHODS

We conducted a pilot single-center observational study involving patients aged ≥ 75 years with insulin-treated diabetes who met the French national criteria for CGM reimbursement. The primary endpoint was feasibility of CGM, defined as the acceptability and continuation of CGM during hospitalization with ≥ 70% sensor activity. Secondary endpoints included hypoglycemia (< 70 mg/dL), factors associated with hypoglycemia and hyperglycemia (> 180 mg/dL), and the clinical, metabolic, and therapeutic determinants of CGM results.

RESULTS

Among 52 patients (median age 85.5 years; 50% women), 46 (89%) continued CGM during hospitalization and 40 (77%) achieved ≥ 70% sensor activity. A total of 61 hypoglycemic episodes were recorded (mean 1.2 per patient), none of which were symptomatic. Mean time below range (< 70 mg/dL) was 1.4 ± 2.1%, and mean time above range (> 180 mg/dL) was 31.9 ± 22.4%. Exploratory analyses showed that time above range was positively correlated with bolus (ρ = 0.72, p < 0.001) and total daily insulin doses (ρ = 0.68, p < 0.001). At discharge, 38 of the 41 patients (96.7%) who remained on insulin were prescribed CGM. No device-related serious adverse events were observed.

CONCLUSIONS

CGM use in an acute geriatric unit was feasible and well tolerated, with a high proportion of analyzable sensor data and limited hypoglycemia. These findings support the integration of CGM into routine inpatient geriatric diabetes care.