ECEESPE2025 Oral Communications Oral Communications 2: Diabetes and Insulin Part 1 (6 abstracts)
In-hospital diabetes management by a diabetes team using insulin algorithms with continuous glucose monitoring or point-of-care testing in patients with type 2 Diabetes: the DIATEC RCT
Mikkel Thor Olsen 1 , Carina Klarskov 1 , Signe Jensen 1 , Louise Rasmussen 1 , Birgitte Lindegaard 1 , Jonas Andersen 1 , Hans Gottlieb 2 , Suzanne Lunding 2 , Ulrik Pedersen-Bjergaard 1 , Katrine Hansen 3 & Peter Kristensen 1
1Copenhagen University Hospital – North Zealand, Hilleroed, Denmark; 2Herlev-Gentofte Hospital, Herlev, Denmark; 3Steno Diabetes Center Copenhagen, Herlev, Denmark
JOINT55
Objective: The DIATEC trial investigates the glycaemic and clinical effects of inpatient continuous glucose monitoring (CGM)-guided insulin titration by diabetes teams.
Research design and methods: This two-centre trial randomised 166 non-intensive care unit patients with type 2 diabetes. Diabetes management was performed by regular staff, guided by diabetes teams using insulin titration algorithms based on either point-of-care glucose testing or CGM. The primary outcome was the difference in time in range (TIR) (3.9–10.0 mmol/l) between the two arms. Outcomes were assessed during the entire hospitalisation.
Results: The CGM-arm achieved a higher TIR (median, IQR) of 77.6% (24.4) vs 62.7% (31.5) in the POC-arm (P<.001). Time above range (TAR) >10.0 mmol/l was lower in the CGM-arm of (median, IQR) 21.1% (24.8) vs 36.5% (30.3) in the POC-arm (P=.001). Time below range (TBR) <3.9 mmol/l was reduced by CGM, with a relative difference to POC of 0.57 (95% CI 0.34–0.97) (P=.042). Prolonged hypoglycaemic events decreased (IRR 0.13, 95% CI 0.04–0.46) (P=.001), and the coefficient of variation (mean, SD) was lower in the CGM-arm of 25.4% (6.3) vs 28.0% (8.2) in the POC-arm (P=.024). Total insulin doses (mean, SD) were reduced in the CGM-arm with 24.1 IU/day (13.9) vs 29.3 IU/day (13.9) in the POC-arm (P=.049). A composite of complications was lower in the CGM-arm (IRR 0.76, 95% CI 0.59–0.98) (P=.032).
Conclusions: In-hospital CGM increased TIR by 15%-points, mainly by reducing TAR. CGM also lowered TBR, glycaemic variability, prolonged hypoglycaemic events, insulin usage, and in-hospital complications.
Volume 110
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Endocrine Abstracts
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