Continuous Glucose Monitoring in Critically Ill Patients With COVID-19: Results of an Emergent Pilot Study.
J Diabetes Sci Technol
; 14(6): 1065-1073, 2020 11.
Article
in English
| MEDLINE | ID: covidwho-873877
ABSTRACT
BACKGROUND:
Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU).METHODS:
Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements.RESULTS:
CGM devices were placed on 11 patients Medtronic (n = 6) and Dexcom G6 (n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of -17.76 mg/dL (Medtronic) and -1.94 mg/dL (Dexcom), with wide 95% limits of agreement.CONCLUSIONS:
During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Blood Glucose
/
Critical Illness
/
Coronavirus Infections
/
Monitoring, Physiologic
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Language:
English
Journal:
J Diabetes Sci Technol
Journal subject:
Endocrinology
Year:
2020
Document Type:
Article
Affiliation country:
1932296820964264
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