Accuracy and feasibility of initiating real-time continuous glucose monitoring in noncritically ill hospitalized patients with type 2 diabetes

doi:10.4239/wjd.124291

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Nov 15, 2026; 17(11): 124291
Published online Nov 15, 2026. doi: 10.4239/wjd.124291

Accuracy and feasibility of initiating real-time continuous glucose monitoring in noncritically ill hospitalized patients with type 2 diabetes

Sirinart Sirinvaravong, Choompunuj Sakjirapapong, Lukana Preechasuk, Nuntakorn Thongtang

Sirinart Sirinvaravong, Choompunuj Sakjirapapong, Nuntakorn Thongtang, Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Krung Thep Maha Nakhon, Thailand

Sirinart Sirinvaravong, Lukana Preechasuk, Nuntakorn Thongtang, Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Krung Thep Maha Nakhon, Thailand

Choompunuj Sakjirapapong, Medicine, Diabetes, Thyroid and Endocrine Center, Phyathai 2 International Hospital, Bangkok 10400, Krung Thep Maha Nakhon, Thailand

Author contributions: Sirinvaravong S, Sakjirapapong C, Preechasuk L, and Thongtang N developed the research design and study protocol, performed patient enrollment and data collection; Sirinvaravong S and Sakjirapapong C performed data analysis and drafted the manuscript; Sirinvaravong S and Thongtang N critically reviewed and revised the manuscript; and all authors have read and approved the submitted version of the manuscript and agree to be individually and collectively responsible for the accuracy of the data.

AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.

Supported by Specific League Funds, No. R016421005.

Institutional review board statement: The study protocol was approved by the Siriraj Institutional Review Board (COA No. Si 644/2021).

Clinical trial registration statement: The study was retrospectively registered in the Thai Clinical Trials Registry (TCTR20230426007; https://www.thaiclinicaltrials.org/show/TCTR20230426007).

Informed consent statement: All participants provided written informed consent before study enrollment.

Conflict-of-interest statement: All authors declare no commercial, personal, political, intellectual, or religious conflicts of interest relating to any aspect of this study.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Nuntakorn Thongtang, MD, Professor, Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Krung Thep Maha Nakhon, Thailand. nutakorn.thn@mahidol.ac.th

Received: June 15, 2026
Revised: July 25, 2026
Accepted: October 8, 2026
Published online: November 15, 2026
Processing time: 148 Days and 0.3 Hours

Abstract

BACKGROUND

Continued use of personal continuous glucose monitoring (CGM) devices is recommended for people with diabetes receiving insulin therapy during hospitalization to achieve better glycemic control and reduce hypoglycemia. However, data on the initiation of real-time CGM (rt-CGM) in hospitalized patients remain limited.

AIM

To evaluate accuracy and feasibility of initiating Glunovo i3 rt-CGM for general-medicine inpatients with type 2 diabetes mellitus (T2DM).

METHODS

A total of 25 patients with T2DM were enrolled. The mean age was 72.8 ± 11.6 years, 64% were female, and the mean glycated hemoglobin was 10.0% ± 3.1%. The Glunovo i3 rt-CGM sensor and transmitter were placed on the patient’s abdomen. Medical personnel calibrated the device using capillary blood glucose (CBG) measurements. Paired CBG and sensor glucose values were analyzed to assess the accuracy of CGM using the mean absolute relative difference (MARD) and Clarke Error Grid Analysis (CEGA).

RESULTS

CGM was used for 7.7 ± 2.4 days, with calibration performed 2.3 ± 0.7 times/day. Among 397 paired CBG and CGM measurements, overall MARD was 12.2% ± 12.2%, with the lowest MARD observed at CBG levels > 180 mg/dL (11.0% ± 11.1%). The percentages of readings within ± 15%/15 mg/dL, ± 20%/20 mg/dL, and ± 30%/30 mg/dL were 72.8%, 82.9%, and 91.7%, respectively. Overall, 96.7% of points fell within CEGA zones A and B, with none in zone E. Time in range improved from 41.2% ± 26.2% on day 1 to 48.3% ± 22.3% during the last 72 hours (P = 0.469).

CONCLUSION

Initiation of the Glunovo i3 rt-CGM system in noncritically ill hospitalized patients with insulin-treated T2DM is feasible and demonstrates acceptable accuracy and safety for glucose monitoring during hospitalization.

Keywords: Continuous glucose monitoring; Inpatient glucose management; Accuracy; Type 2 diabetes mellitus; Insulin therapy

Core Tip: Evidence regarding the initiation of real-time continuous glucose monitoring (rt-CGM) in hospitalized adults remains scarce. This study evaluated the accuracy and feasibility of initiating the Glunovo i3 rt-CGM system for inpatient glycemic monitoring among 25 patients with type 2 diabetes mellitus (T2DM) admitted to non-intensive care unit medical wards. Among 397 paired capillary blood glucose and sensor glucose measurements, the mean absolute relative difference was 12.2%, with 96.7% of values falling within zones A and B of the Clarke Error Grid Analysis. These findings suggest that initiating rt-CGM in hospitalized patients with T2DM is feasible and demonstrates acceptable accuracy for glucose monitoring.