Impact of Meal Insulin Bolus Timing and Bedtime Snacking on Continuous Glucose Monitoring–Derived Glycemic Metrics in Hospitalized Inpatients
Authors' conclusion
Delayed mealtime insulin administration and bedtime snacking without insulin administration are significant causes of postprandial and overnight hyperglycemia in hospitalized inpatients.
Study context
- Population
- Hospitalized inpatients with T2D in an RCT of Fiasp vs insulin aspart (Novolog), who completed the protocol incl. Continuous glucose monitoring (CGM) for ≥4 meals122 analysed
- Participants
- 149 vs 112
- Comparison
- Meal insulin bolus before meals vs delayed >5 min after meal; bedtime snacking without prandial insulin
- Before mealsn = 149
- Delayedn = 112reference
- Primary endpoint
- Postprandial TIR70-180
- Follow-up
- 4 hours postprandial
Methodological detailsCGM-assessed (Dexcom G6 PRO)
- CGM-assessed (Dexcom G6 PRO)
Primary result
As reported in the abstract
4 hours
P < 0.001
Further findings
Bedtime snacking (9 pm-12 am): fasting glucose next morning
- Higher fasting glucose with bedtime snacking
- 35.2 mg/dL, SE = 15.4, P = 0.026
- Adjusted for bedtime sensor glucose
Bedtime snacking: overnight (9 pm-6 am) time in range (TIR70-180)
- Reduced overnight TIR70-180 with bedtime snacking
- 31.9%, SE = 8.06, P < 0.001
- Adjusted for bedtime sensor glucose
Bedtime snacking: overnight glucose SD
- Higher overnight glucose SD with bedtime snacking
- 12.3 mg/dL, SE = 3.46, P < 0.001
- Adjusted for initial bedtime sensor glucose
Bedtime snacking: overnight glucose %CV
- Higher overnight glucose %CV with bedtime snacking
- 3.6%; SE = 1.7, P = 0.044
- Adjusted for initial bedtime sensor glucose
Original publication
Impact of Meal Insulin Bolus Timing and Bedtime Snacking on Continuous Glucose Monitoring–Derived Glycemic Metrics in Hospitalized Inpatients. Diabetes Technol Ther. Published 11 March 2025. doi:10.
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