Continuous Glucose Monitoring Improves Detection of Clinically Significant Dysglycemia in Hospitalized Patients With Type 2 Diabetes or Hyperglycemia: A Prospective Real-World Study

Continuous glucose monitoring (CGM) is increasingly used for inpatient glycemic surveillance, but evidence in non-critical care wards remains limited, particularly in real-world public healthcare settings. Intermittent capillary glucose testing may fail to detect transient, nocturnal, or asymptomatic dysglycemia. We sought to evaluate whether CGM improves detection of clinically significant dysglycemia compared with seven-point capillary glucose monitoring in hospitalized patients with type 2 diabetes mellitus or hyperglycemia. This is a prospective, observational, non-randomized, real-world study performed in a tertiary referral center in Mexico. 56 hospitalized patients were included: 28 underwent flash CGM and 28 underwent seven-point capillary glucose monitoring. Patients were followed for up to 6 hospitalization days. The main analytical focus was detection of clinically significant dysglycemia, including hypoglycemia <70 mg/dL, clinically significant hypoglycemia <54 mg/dL, and severe hyperglycemia >250 mg/dL. Secondary outcomes included time in range, mean daily glucose, insulin requirements, infectious complications, length of stay, and mortality. CGM detected more hypoglycemia <70 mg/dL than capillary monitoring (71.4% vs 35.7%, p=0.005), more clinically significant hypoglycemia <54 mg/dL (median 3 [IQR 0-6.5] vs 0, p=0.030), and more severe hyperglycemia >250 mg/dL (median 8.5 [IQR 0.5-17] vs 0 [IQR 0-9.52], p=0.030). Time in range was not significantly different between groups (59.86 +/- 23.46% vs 69.28 +/- 24.99%, p=0.151). After adjustment for age, diabetes duration, and admission hyperglycemia, CGM remained associated with hypoglycemia detection (OR 4.7, 95% CI 1.2-19.0, p=0.027). We concluded that CGM improved detection of clinically significant dysglycemia during up to 6 hospitalization days. Although CGM did not improve time in range or short-term clinical outcomes, it provided superior glycemic surveillance compared with intermittent capillary glucose testing.