INNV-44. Feasibility Study of Continuous Glucose Monitoring in Brain Tumor Patients with Steroid-Induced Hyperglycemia

Abstract BACKGROUND Steroid-induced hyperglycemia (SIH) is a common, yet under-recognized, complication in brain tumor patients undergoing glucocorticoid therapy, particularly in the perioperative setting. SIH is associated with poor clinical outcomes, including increased infection rates, delayed healing, neurologic complications, and reduced survival. Current monitoring via self-monitoring of blood glucose (SMBG) is often poorly adhered to due to its invasive and burdensome nature. Continuous glucose monitoring systems (CGMS), such as the Freestyle Libre, offer a minimally invasive, real-time alternative with the potential to improve adherence, glycemic control, and overall outcomes in this high-risk population. OBJECTIVE To evaluate the feasibility, safety, and preliminary clinical impact of CGMS compared to SMBG in brain tumor patients who develop SIH following perioperative steroid therapy. METHODS This is a 12-month, single-center, randomized controlled feasibility trial at UNC Hospitals enrolling 60 adult patients undergoing brain tumor resection who develop SIH. Participants will be randomized 1:1 to CGMS or standard SMBG, with 9 months of follow-up. Primary outcomes include CGMS adherence, sensor wear time, data capture rates, and retention. Secondary outcomes include glycemic control (time-in-range, hypoglycemia, hyperglycemia), patient satisfaction, provider usability feedback, and exploratory clinical endpoints such as infection rates, length of stay, and readmissions. Economic analyses will assess the cost-effectiveness of CGMS implementation. SIGNIFICANCE This study addresses a critical gap in the management of treatment-induced hyperglycemia in neuro-oncology. By assessing the feasibility and impact of CGMS in this context, findings will inform future large-scale trials and support the development of precision strategies to optimize metabolic care for brain tumor patients receiving steroids. Results will also contribute to a broader NIH-funded research agenda focused on digital health integration in complex surgical populations.