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

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