Technology in the management of diabetes in hospitalised adults

Diabetologia. 2024 Oct;67(10):2114-2128. doi: 10.1007/s00125-024-06206-4. Epub 2024 Jul 2.

Abstract

Suboptimal glycaemic management in hospitals has been associated with adverse clinical outcomes and increased financial costs to healthcare systems. Despite the availability of guidelines for inpatient glycaemic management, implementation remains challenging because of the increasing workload of clinical staff and rising prevalence of diabetes. The development of novel and innovative technologies that support the clinical workflow and address the unmet need for effective and safe inpatient diabetes care delivery is still needed. There is robust evidence that the use of diabetes technology such as continuous glucose monitoring and closed-loop insulin delivery can improve glycaemic management in outpatient settings; however, relatively little is known of its potential benefits and application in inpatient diabetes management. Emerging data from clinical studies show that diabetes technologies such as integrated clinical decision support systems can potentially mediate safer and more efficient inpatient diabetes care, while continuous glucose sensors and closed-loop systems show early promise in improving inpatient glycaemic management. This review aims to provide an overview of current evidence related to diabetes technology use in non-critical care adult inpatient settings. We highlight existing barriers that may hinder or delay implementation, as well as strategies and opportunities to facilitate the clinical readiness of inpatient diabetes technology in the future.

Keywords: Automated insulin delivery; Clinical decision support; Diabetes technology; Glucose sensor; Hospital; Non-critical care; Review.

Publication types

  • Review

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring
  • Decision Support Systems, Clinical
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / therapy
  • Glycemic Control / methods
  • Hospitalization
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Inpatients
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Insulin Infusion Systems*

Substances

  • Blood Glucose
  • Insulin
  • Hypoglycemic Agents