[Expert consensus on the clinical application of continuous glucose monitoring in adult patients during the perioperative period (2026 edition)].

Abstract

Perioperative glycemic abnormalities, including hyperglycemia, hypoglycemia, and glycemic variability, are important determinants of postoperative outcomes. Conventional glucose monitoring has inherent temporal limitations and fails to capture dynamic glycemic fluctuations in a timely manner. Continuous glucose monitoring (CGM) enables real-time, continuous assessment of glucose levels and trends, thereby facilitating more precise glycemic management. To standardize its clinical application, the Chinese Society of Anesthesiology, in collaboration with the National Alliance of Geriatric Anesthesia, convened a multidisciplinary expert panel to develop the "Expert consensus on the clinical application of CGM in adult patients during the perioperative period (2026 edition)". Key clinical issues, including monitoring strategies across different perioperative phases, data interpretation, and management of special populations, were systematically reviewed and deliberated by the expert panel, resulting in 20 recommendations. This consensus applies primarily to adults with diabetes scheduled to undergo surgery and adults at high risk of perioperative glycemic variability. It covers risk assessment for perioperative dysglycemia, interpretation of CGM data, preoperative initiation and assessment, and intraoperative monitoring and confirmatory testing. It also addresses postoperative handover and continued management, together with the use of CGM in special populations and specific surgical settings. This consensus aims to guide the standardized perioperative use of CGM, optimize glycemic management and improve patient safety.