A New Era of Smart Diabetes Care – Tri-Service General Hospital Introduces Continuous Glucose Monitoring for Enhanced Diabetes Management
Update Date：2026/02/06，
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Endocrinology and Metabolism Department, Dr. Ho Li-Ru
Continuous Glucose Monitoring and Closed-Loop Insulin Systems: Making Diabetes Management More Precise and Safe
With the rapid development of digital healthcare and artificial intelligence technology, diabetes care is entering a new era of “real-time, personalized, and smart” management. Dr. Ho Li-Ru from the Department of Endocrinology and Metabolism at Tri-Service General Hospital points out that the combination of Continuous Glucose Monitoring (CGM), smart insulin pumps, and closed-loop insulin delivery systems is gradually transforming traditional blood sugar management, offering diabetes patients a new choice for more stable and safer blood sugar control.
Continuous Glucose Monitoring (CGM): Moving from “Spot Measurement” to “24/7 Monitoring”
Dr. Ho shared the case of a 50-year-old female patient who has had Type 1 diabetes (T1DM) for over 24 years. She has faced significant blood sugar fluctuations for years, and long-term poor metabolic control has led to severe kidney damage, now diagnosed as diabetic nephropathy.
To precisely track blood sugar fluctuations and delay further kidney function deterioration, the patient recently visited Tri-Service General Hospital’s Department of Endocrinology. After evaluation, the medical team decided to admit her for insulin pump rate adjustments and to insert a CGM system at her own expense. With CGM providing continuous 24-hour data, the team was able to detect hidden blood sugar fluctuations in real-time, adjust the treatment strategy, optimize blood sugar control, and enhance organ protection.
In contrast to traditional blood glucose meters that only allow intermittent fingerstick measurements, CGM measures glucose levels every 5 minutes, accumulating 288 readings per day. The system works by wearing a sensor on the arm that detects glucose concentration changes in the interstitial fluid beneath the skin. The data is then transmitted in real-time to a receiver or smartphone, helping users track blood sugar trends comprehensively.
Dr. Ho explained that while CGM measures “interstitial glucose,” which has a slight time lag compared to blood glucose, its real-time trends and visual analytics provide a more accurate reflection of overall glucose variations, aiding in clinical judgment and daily self-management.
More Than Just HbA1c – CGM Reveals “Blood Sugar Quality”
Clinically, even if two patients have the same HbA1c value, their blood sugar stability and risk of hypoglycemia can vary significantly. CGM provides key indicators such as Time in Range (TIR), Ambulatory Glucose Profile (AGP), and Coefficient of Variation (CV%), which offer a more precise representation of blood sugar control quality. These metrics help physicians and patients develop personalized dietary and treatment strategies.
Towards Automation: Closed-Loop Insulin Delivery System
As CGM and insulin pumps are integrated, the closed-loop insulin delivery system is becoming more advanced. This system automatically adjusts basal insulin infusion based on real-time blood sugar data and delivers small corrective doses of insulin when blood sugar rises, reducing the risk of oscillating between high and low blood sugar levels.
For example, the latest generation of systems automatically adjusts insulin every 5 minutes, using algorithms to analyze the safety of pre-meal and correctional doses. This improves overall blood sugar control stability without increasing the risk of hypoglycemia.
From “Ideal Patients” to “Clinical Practice”: More People Benefiting
In the past, insulin pumps were often considered suitable only for "ideal patients" with high education levels and good adherence. However, clinical experience shows that even patients with unstable blood sugar, irregular lifestyles, or difficulty accurately calculating carbohydrate intake can achieve significant benefits from smart insulin pump therapy with appropriate education and support from the medical team.
For children and adults with Type 1 diabetes, insulin pumps are especially valuable for patients experiencing frequent hypoglycemia, large blood sugar variability, dawn phenomenon, or those who wish to improve their quality of life.
Opening a New Chapter in Smart Diabetes Care
Dr. Ho emphasized that the integration of CGM, insulin pumps, and AI algorithms is shifting diabetes care from “passive correction” to “active prediction and real-time adjustment.” In the future, with more precise data and intelligent systems, diabetes patients will be able to achieve more stable blood sugar control and enjoy a better quality of life, all while ensuring safety.
