Inpatient Diet Orders and Continuous Glucose Monitoring in Noncritically Ill, Hospitalized Adult Patients.

Abstract

Objectives: Inpatient diet orders are commonly prescribed in clinical practice and may influence the glycemic management in hospitalized patients, yet empirical data remain limited. This study aimed to evaluate the relationship between diet orders and continuous glucose monitoring (CGM) derived glycemic measures in noncritically ill hospitalized adults.

Methods: This secondary analysis used data from a prospective, observational study. Inpatient diet orders were extracted from clinical documentation and standardized into 11 general diet order categories. The primary outcome was percent time in range (70-180 mg/dL). Secondary outcomes included time above range, time below range, and glycemic variability. Associations were examined using multivariate linear mixed-effects models, accounting for demographics, insulin therapy, and other relevant medications.

Results: The analytical sample included 283 hospitalized adults (mean age 60.7 years, body mass index 38.5 kg/m², 36.4% female), primarily admitted to medical units, with most having type 2 diabetes (77.4%). CGM-derived glycemic measures and insulin therapy use varied significantly across inpatient diet orders. Compared to a regular diet, a regular diet with restrictions was associated with lower time in range and higher time above range, whereas diabetic and liquid diets were associated with higher time below range. Measures of glucose variability did not differ across diet orders.

Conclusions: Inpatient diet orders are modestly associated with 24-hour CGM-derived glycemic measures adjusted by insulin therapy and other related medications. Future research is needed to standardize diet order classifications and assess their impact on inpatient glycemic management.