As the use of continuous glucose monitoring (CGM) has become standard of care, the question has remained whether CGM can be used as effectively in the hospital as it is in the outpatient setting. A Monday, June 24, symposium will feature a panel of investigators who will share findings from the TIGHT study, which looked to answer that question.

Results from a Randomized Trial of Intensive Glucose Management Using Continuous Glucose Monitoring (CGM) Versus Usual Care in Hospitalized Adults with Type 2 Diabetes—The TIGHT Study will take place from 3:15 p.m. – 4:15 p.m. ET in Room W320, the Chapin Theater, of the Orange County Convention Center. The symposium also will be livestreamed on the virtual meeting platform for registered meeting participants and will be available on-demand following the 84^th Scientific Sessions.

“The TIGHT trial sought to determine whether we can safely use CGM when patients are admitted to the hospital and if we can do a better job of controlling their blood sugars with CGM than without CGM,” said TIGHT Study Chair Irl B. Hirsch, MD, Professor and Diabetes Treatment and Teaching Chair at the University of Washington (UW) School of Medicine and UW Medicine Diabetes Institute.

Among the challenges the TIGHT investigators faced, and a challenge in the use of CGM in the hospital setting in general, is the scarcity of dedicated in-hospital diabetes care teams, particularly in public and community hospitals, he noted.

“When we look at the findings from the TIGHT trial, it’s important to consider that we looked only at academic medical centers that already have glycemic control teams in the hospital, so these hospitals may have a bit of an advantage compared to the average community hospital,” Dr. Hirsch said. “Additionally, while the ADA has specific targets for glucose control in the hospital and we all try to go by those targets, there is no consensus approach or algorithm for how you get to those targets.”

Among the reasons for that, he noted, are the cultures of hospitals are different, the workforces are different, and the nurse-to-patient ratios are different from hospital to hospital.

“No matter what the TIGHT results show, the differences in the culture of insulin use and differences in hospital workforce composition and availability create a real struggle for people who take care of patients with diabetes in the hospital,” Dr. Hirsch said. “More than anything, we hope the TIGHT results will open up communication, not just about CGM use and how we take care of our type 2 diabetes patients in the hospital, but also about the evolution of diabetes technology in general.”

If a patient is using CGM or an insulin pump and is hospitalized, they should not have to stop using that technology during their hospitalization, he continued.

Dr. Hirsch’s presentation will focus on the study results and conclusions. Guillermo Umpierrez, MD, CDCES, MACP, FACE, Professor of Medicine, Emory University, will review the study results. Boris Draznin, MD, PhD, Visiting Clinical Professor of Medicine-Endocrinology, Metabolism, and Diabetes and Director of the Adult Diabetes Program, University of Colorado, Denver, will present the study background and rationale. Jagdeesh Ullal, MD, MS, FACE, FACP, ECNU, Clinical Associate Professor of Medicine and Clinic Lead for Inpatient and Subspecialty Diabetes, University of Pittsburgh Medical Center, will discuss the study methods.