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Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic

OBJECTIVE: Real-time continuous glucose monitoring (rtCGM) in critically ill hospitalized patients holds promise; however, real-world data are needed. RESEARCH DESIGN AND METHODS: We placed Dexcom G6 CGM on intensive care unit (ICU) patients at Montefiore Medical Center with confirmed coronavirus di...

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Autores principales: Agarwal, Shivani, Mathew, Justin, Davis, Georgia M., Shephardson, Alethea, Levine, Ann, Louard, Rita, Urrutia, Agustina, Perez-Guzman, Citlalli, Umpierrez, Guillermo E., Peng, Limin, Pasquel, Francisco J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896255/
https://www.ncbi.nlm.nih.gov/pubmed/33361145
http://dx.doi.org/10.2337/dc20-2219
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author Agarwal, Shivani
Mathew, Justin
Davis, Georgia M.
Shephardson, Alethea
Levine, Ann
Louard, Rita
Urrutia, Agustina
Perez-Guzman, Citlalli
Umpierrez, Guillermo E.
Peng, Limin
Pasquel, Francisco J.
author_facet Agarwal, Shivani
Mathew, Justin
Davis, Georgia M.
Shephardson, Alethea
Levine, Ann
Louard, Rita
Urrutia, Agustina
Perez-Guzman, Citlalli
Umpierrez, Guillermo E.
Peng, Limin
Pasquel, Francisco J.
author_sort Agarwal, Shivani
collection PubMed
description OBJECTIVE: Real-time continuous glucose monitoring (rtCGM) in critically ill hospitalized patients holds promise; however, real-world data are needed. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-78962552021-02-22 Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic Agarwal, Shivani Mathew, Justin Davis, Georgia M. Shephardson, Alethea Levine, Ann Louard, Rita Urrutia, Agustina Perez-Guzman, Citlalli Umpierrez, Guillermo E. Peng, Limin Pasquel, Francisco J. Diabetes Care Novel Communications in Diabetes OBJECTIVE: Real-time continuous glucose monitoring (rtCGM) in critically ill hospitalized patients holds promise; however, real-world data are needed. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. American Diabetes Association 2021-03 2020-12-23 /pmc/articles/PMC7896255/ /pubmed/33361145 http://dx.doi.org/10.2337/dc20-2219 Text en © 2020 by the American Diabetes Association https://www.diabetesjournals.org/content/licenseReaders may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/content/license.
spellingShingle Novel Communications in Diabetes
Agarwal, Shivani
Mathew, Justin
Davis, Georgia M.
Shephardson, Alethea
Levine, Ann
Louard, Rita
Urrutia, Agustina
Perez-Guzman, Citlalli
Umpierrez, Guillermo E.
Peng, Limin
Pasquel, Francisco J.
Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title_full Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title_fullStr Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title_full_unstemmed Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title_short Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
title_sort continuous glucose monitoring in the intensive care unit during the covid-19 pandemic
topic Novel Communications in Diabetes
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896255/
https://www.ncbi.nlm.nih.gov/pubmed/33361145
http://dx.doi.org/10.2337/dc20-2219
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