Division of Endocrinology, Diabetes & Metabolism, The Ohio State University College of Medicine, 5th Floor McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210-1296, USA.
The Ohio State University College of Nursing, Columbus, OH, USA.
Curr Diab Rep. 2022 Sep;22(9):451-460. doi: 10.1007/s11892-022-01484-x. Epub 2022 Jul 7.
The use of continuous glucose monitoring (CGM) in the hospital setting is growing with more patients using these devices at home and when admitted to the hospital, especially during the COVID-19 pandemic.
Historically, most evidence for CGM use in the inpatient setting was limited to small studies utilizing outdated CGM technology and analyzing accuracy of sensor measurements. Previous studies have shown reduced sensor accuracy during extreme hypo- or hyperglycemia, rapid fluctuations of glucose, compression of the sensor itself, and in those who are critically ill. Studies that are more recent have shown CGM to have adequate accuracy and may be effective in reducing hypoglycemia in hospitalized patients; some studies have also showed improvement in time in target glycemic range. Furthermore, CGM may reduce nursing workload, cost of inpatient care, and use of personal protective equipment and face-to-face patient care especially for patients during the COVID-19 pandemic. This review will describe the evidence for use of CGM in hospitalized critically ill or non-critically ill patients, address accuracy and safety considerations, and outline paths for future implementation.
随着越来越多的患者在家中以及住院期间使用这些设备，特别是在 COVID-19 大流行期间，连续血糖监测（CGM）在医院环境中的使用正在增加。
从历史上看，CGM 在住院患者中的应用证据主要限于利用过时的 CGM 技术的小型研究，以及对传感器测量准确性的分析。以前的研究表明，在极端低血糖或高血糖、血糖快速波动、传感器本身受压以及病情严重的患者中，传感器的准确性会降低。更新的研究表明，CGM 具有足够的准确性，并可能有效降低住院患者的低血糖发生率；一些研究还表明，目标血糖范围内的时间有所改善。此外，CGM 可以减少护士的工作量、住院护理成本以及个人防护设备的使用和面对面的患者护理，特别是在 COVID-19 大流行期间的患者。本综述将描述 CGM 在住院危重症或非危重症患者中的应用证据，讨论准确性和安全性问题，并概述未来实施的途径。
