How One Hospital is Using CGM Technology to Improve Insulin Dosing in Children

When children with type 1 diabetes are hospitalized, keeping blood sugar stable is a key part of recovery. Traditionally, hospitals have relied on finger-stick blood glucose tests to decide when and how much insulin to give. A new study from a pediatric hospital shows that continuous glucose monitors (CGMs)—devices that track blood sugar throughout the day—can do this job safely and accurately.

Researchers developed a hospital-wide policy that lets nurses use CGM readings to guide insulin dosing, as long as the CGM accuracy is verified first. The policy was used in 93 hospital stays involving 60 patients between September 2024 and October 2025.

Before using a CGM to make insulin decisions, nurses had to check its accuracy by comparing CGM readings to finger-stick blood glucose tests. This validation step was successful in about 8 out of 10 attempts (81.5%). When looking at over 1,200 paired readings, the CGM measurements differed from blood glucose tests by an average of 12.6%—a level considered acceptable for clinical use.

When CGM readings didn't match finger-stick tests, nurses responded appropriately nearly 98% of the time, either by rechecking or adjusting their insulin dosing plan. This shows the policy worked as intended: CGMs could be trusted, but with built-in safeguards.

Among the 58 hospital stays with complete glucose data, children spent an average of 54.8% of their time in the target blood sugar range of 70–180 mg/dL. This is meaningful because time in range is linked to better health outcomes during hospitalization and faster recovery.

Severe low blood sugar—a key safety concern—was rare. Time spent below 54 mg/dL (level 2 hypoglycemia) was just 0.8% across all monitored stays. This low rate suggests the policy helped prevent dangerous drops in blood sugar.

The study also asked nurses for their feedback on using CGMs versus traditional finger-stick testing for insulin dosing. Nurses strongly preferred the CGM approach, citing three main reasons: the devices were easier to use, they fit naturally into the hospital's computer systems, and staff could learn the system quickly.

This preference matters because buy-in from the people actually using the technology is crucial for any new hospital policy to succeed. When nurses feel confident and supported, patients benefit.

This study shows one hospital's successful implementation of CGM-guided insulin dosing in children. Most of the CGMs used were the Dexcom G7 (about half of cases) and Abbott Libre 3 or 3 Plus devices (about one-third of cases), and the approach worked well with automated insulin delivery systems too.

While this research is specific to one hospital's experience, it suggests that CGM technology—with accuracy checks built in—can be a safe and effective tool for managing insulin in pediatric hospital settings. As more hospitals adopt similar policies, this approach may become standard practice.

Source: Diabetes technology & therapeutics. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.