Use of an insulin titration protocol based on continuous glucose monitoring in postoperative cardiac surgery patients with type 2 diabetes and prediabetes: a randomized controlled trial
An erratum to this article was published (Cardiovasc Diabetol, 13 Sep 2025 ↗)
Authors' conclusion
While the primary outcome was not achieved, CGM with a specialized titration protocol demonstrated safe glycemic control with improvements in TIR 70-180 mg/dL and TITRs in cardiac surgery patients with T2D and prediabetes. The observed reduction in postoperative AF warrants further investigation.
Study context
- Population
- Cardiac surgery patients with T2D or prediabetes, randomized one day post-surgery; 31 (59.6%) had diabetes and 21 (40.4%) prediabetesrandomized one day post-surgery
- Participants
- 54 patients
- Comparison
- Continuous glucose monitoring (CGM) with a CGM-specialized insulin titration protocol vs point-of-care (POC) glucose monitoring
- CGMn = 27
- POCn = 25reference
- Primary endpoint
- TIR 100-180 mg/dL
- Follow-up
- 7 days post-surgery
Methodological detailsMultiple comparison adjustment by false-discovery-rate (FDR)
- Multiple comparison adjustment by false-discovery-rate (FDR)
Primary result
As reported in the abstract
- Time-in-range (TIR) 100-180 mg/dL showed no difference
- CGM vs POC: FDR-adjusted p = 0.376
- Primary outcome not achieved
Secondary outcomes
TIR 70-180 mg/dL
FDR-adjusted p = 0.026
Time in tight range (TITR) 100-140 mg/dL
FDR-adjusted p = 0.018
TITR 70-140 mg/dL
FDR-adjusted p = 0.003
Postoperative AF · lower with CGM
FDR-adjusted p = 0.04999
Safety
| Outcome | P value |
|---|---|
| TBR (<70 mg/dL) | FDR-adjusted p = 0.109 |
TBR (<70 mg/dL)
- Both groups maintained very low rates of time below range
Original publication
Use of an insulin titration protocol based on continuous glucose monitoring in postoperative cardiac surgery patients with type 2 diabetes and prediabetes: a randomized controlled trial. Cardiovasc Diabetol. Published 14 May 2025. doi:10.
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