Katsnelson Glen, Salvatori Marcus, Djaiani George, Greer Elise, Tarshis Jordan, Katznelson Rita
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Diving Hyperb Med. 2025 Jun 30;55(2):164-172. doi: 10.28920/dhm55.2.164-172.
Continuous glucose monitoring devices (CGMs) have emerged as an effective approach to optimise glycaemic control for individuals living with diabetes mellitus. Despite CGMs offering improved patient satisfaction and quality of life, they have been primarily validated for outpatient and home use. This has posed a challenge for patients and providers who wish to incorporate CGMs into clinical settings such as hyperbaric oxygen therapy (HBOT). Those with advanced diabetes mellitus who have diabetic foot ulcers that are refractory to treatment are among the most prevalent users of HBOT. However, those who prefer to use their CGM during HBOT face uncertainty regarding the accuracy and safety of their device under hyperbaric conditions.
The product specifications of commonly used CGMs were collated. In addition, a scoping review of the literature was conducted where Medline, Embase, and Scopus were searched for reports that assess the accuracy or safety of CGMs in hyperbaric conditions.
The product specifications of commonly used CGMs by Dexcom, Abbott, Medtronic, and Senseonics demonstrate a maximum validated pressure of approximately 106 kPa (1.06 atmospheres absolute). Our literature search identified five reports, of which four focused on accuracy and one focused on safety of CGMs in hyperbaric conditions. Treatments were conducted in multiplace chambers and cumulatively described 39 participants, of whom 12 have diabetes. Although heterogeneous in nature, the reports generally supported the safety and accuracy of CGMs in hyperbaric conditions.
The safety and accuracy of using CGMs during HBOT warrants further investigation. CGMs have not been validated for repeated exposure to hyperbaric conditions and should not be used in oxygen pressurised monoplace chambers until further safety data is available. We provide practical recommendations for use of CGMs in multiplace chambers.
连续血糖监测设备（CGM）已成为优化糖尿病患者血糖控制的有效方法。尽管CGM提高了患者满意度和生活质量，但它们主要是针对门诊和家庭使用进行验证的。这给希望将CGM纳入高压氧治疗（HBOT）等临床环境的患者和医护人员带来了挑战。患有晚期糖尿病且糖尿病足溃疡难治的患者是HBOT最常见的使用者之一。然而，那些希望在HBOT期间使用CGM的患者，对于其设备在高压条件下的准确性和安全性存在疑虑。
整理了常用CGM的产品规格。此外，进行了一项文献综述，在Medline、Embase和Scopus数据库中搜索评估CGM在高压条件下准确性或安全性的报告。
德康、雅培、美敦力和先声等公司常用CGM的产品规格显示，最大验证压力约为106 kPa（绝对压力1.06个大气压）。我们的文献检索确定了五份报告，其中四份关注CGM在高压条件下的准确性，一份关注安全性。治疗在多人舱中进行，累计描述了39名参与者，其中12人患有糖尿病。尽管报告性质各异，但总体上支持CGM在高压条件下的安全性和准确性。
在HBOT期间使用CGM的安全性和准确性值得进一步研究。CGM尚未经过反复暴露于高压条件下的验证，在获得更多安全数据之前，不应在单人氧舱中使用。我们提供了在多人舱中使用CGM的实用建议。
