Fleischer Institute for Diabetes and Metabolism, New York Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY
Montefiore Medical Center, Bronx, NY.
Diabetes Care. 2021 Mar;44(3):847-849. doi: 10.2337/dc20-2219. Epub 2020 Dec 23.
Real-time continuous glucose monitoring (rtCGM) in critically ill hospitalized patients holds promise; however, real-world data are needed.
We placed Dexcom G6 CGM on intensive care unit (ICU) patients at Montefiore Medical Center with confirmed coronavirus disease 2019 (COVID-19) infection and glycemic variability. We analyzed inpatient CGM accuracy using point-of-care (POC) glucose-CGM matched pairs and included patients for analysis regardless of clinical status.
We included 11 patients with CGM: 8 on continuous insulin infusion (CII), 8 on vasopressors, 8 intubated, 4 on high-dose glucocorticoids, 6 on renal replacement therapy, and 2 with anasarca. Accuracy was 12.58% for mean and 6.3% for median absolute relative difference. CGM reduced POC testing by ∼60% for patients on CII.
In this real-world preliminary analysis of rtCGM during critical illness, we demonstrate early feasibility, considerable accuracy, and meaningful reduction in the frequency of POC glucose testing.
实时连续血糖监测(rtCGM)在重症住院患者中具有应用前景,但仍需要真实世界的数据。
我们在莫奈菲奥雷医疗中心(Montefiore Medical Center)对确诊为 2019 年冠状病毒病(COVID-19)感染且血糖变异性高的重症监护病房(ICU)患者放置 Dexcom G6 CGM。我们使用即时血糖仪(POC)-CGM 匹配对分析住院患者 CGM 的准确性,并对无论临床状况如何的患者进行分析。
我们纳入了 11 名 CGM 患者:8 名接受持续胰岛素输注(CII),8 名使用血管加压素,8 名插管,4 名使用大剂量糖皮质激素,6 名接受肾脏替代治疗,2 名出现水肿。平均绝对相对差异的准确度为 12.58%,中位数为 6.3%。CGM 使接受 CII 的患者 POC 检测次数减少了约 60%。
在这项重症疾病实时 CGM 的真实世界初步分析中,我们展示了早期的可行性、相当高的准确性以及 POC 血糖检测频率的显著降低。