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Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center

OBJECTIVE: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosin...

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Autores principales: Dumitrascu, Adrian G., Perry, Michelle F., Boone, Rebecca J., Guzman, Maria P., Chirila, Razvan M., McNally, Allyson W., Colibaseanu, Dorin T., Meek, Shon E., Ball, Colleen T., White, Launia J., Chindris, Ana-Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AACE. Published by Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773786/
https://www.ncbi.nlm.nih.gov/pubmed/36566985
http://dx.doi.org/10.1016/j.eprac.2022.12.012
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author Dumitrascu, Adrian G.
Perry, Michelle F.
Boone, Rebecca J.
Guzman, Maria P.
Chirila, Razvan M.
McNally, Allyson W.
Colibaseanu, Dorin T.
Meek, Shon E.
Ball, Colleen T.
White, Launia J.
Chindris, Ana-Maria
author_facet Dumitrascu, Adrian G.
Perry, Michelle F.
Boone, Rebecca J.
Guzman, Maria P.
Chirila, Razvan M.
McNally, Allyson W.
Colibaseanu, Dorin T.
Meek, Shon E.
Ball, Colleen T.
White, Launia J.
Chindris, Ana-Maria
author_sort Dumitrascu, Adrian G.
collection PubMed
description OBJECTIVE: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia. METHODS: Study patients were fitted with a remotely monitored CGM. CGM values were evaluated against glucometer readings. The CGM sensor calibration was performed if necessary. CGM values were used to dose insulin, without glucometer confirmation. RESULTS: CGM accuracy against glucometer, expressed as mean absolute relative difference (MARD), was calculated using 812 paired glucometer-CGM values. The aggregate MARD was 10.4%. For time in range and grades 1 and 2 hyperglycemia, MARD was 11.4%, 9.4%, and 9.1%, respectively, with a small variation between medical floors and intensive care units. There was no MARD correlation with mean arterial blood pressure levels, oxygen saturation, daily hemoglobin levels, and glomerular filtration rates. CGM clinical reliability was high, with 99.7% of the CGM values falling within the “safe” zones of Clarke error grid. After CGM placement, the frequency of glucometer measurements decreased from 5 to 3 and then 2 per day, reducing nurse presence in patient rooms and limiting viral exposure. CONCLUSION: With twice daily, on-demand calibration, the inpatient CGM use was safe for insulin dosing, decreasing the frequency of glucometer fingersticks. For glucose levels >70 mg/dL, CGMs showed adequate accuracy, without interference from vital and laboratory values.
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spelling pubmed-97737862022-12-22 Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center Dumitrascu, Adrian G. Perry, Michelle F. Boone, Rebecca J. Guzman, Maria P. Chirila, Razvan M. McNally, Allyson W. Colibaseanu, Dorin T. Meek, Shon E. Ball, Colleen T. White, Launia J. Chindris, Ana-Maria Endocr Pract Original Article OBJECTIVE: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia. METHODS: Study patients were fitted with a remotely monitored CGM. CGM values were evaluated against glucometer readings. The CGM sensor calibration was performed if necessary. CGM values were used to dose insulin, without glucometer confirmation. RESULTS: CGM accuracy against glucometer, expressed as mean absolute relative difference (MARD), was calculated using 812 paired glucometer-CGM values. The aggregate MARD was 10.4%. For time in range and grades 1 and 2 hyperglycemia, MARD was 11.4%, 9.4%, and 9.1%, respectively, with a small variation between medical floors and intensive care units. There was no MARD correlation with mean arterial blood pressure levels, oxygen saturation, daily hemoglobin levels, and glomerular filtration rates. CGM clinical reliability was high, with 99.7% of the CGM values falling within the “safe” zones of Clarke error grid. After CGM placement, the frequency of glucometer measurements decreased from 5 to 3 and then 2 per day, reducing nurse presence in patient rooms and limiting viral exposure. CONCLUSION: With twice daily, on-demand calibration, the inpatient CGM use was safe for insulin dosing, decreasing the frequency of glucometer fingersticks. For glucose levels >70 mg/dL, CGMs showed adequate accuracy, without interference from vital and laboratory values. AACE. Published by Elsevier Inc. 2023-03 2022-12-22 /pmc/articles/PMC9773786/ /pubmed/36566985 http://dx.doi.org/10.1016/j.eprac.2022.12.012 Text en © 2022 AACE. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Article
Dumitrascu, Adrian G.
Perry, Michelle F.
Boone, Rebecca J.
Guzman, Maria P.
Chirila, Razvan M.
McNally, Allyson W.
Colibaseanu, Dorin T.
Meek, Shon E.
Ball, Colleen T.
White, Launia J.
Chindris, Ana-Maria
Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title_full Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title_fullStr Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title_full_unstemmed Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title_short Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center
title_sort continuous glucose monitoring for patients with covid-19 pneumonia: initial experience at a tertiary care center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773786/
https://www.ncbi.nlm.nih.gov/pubmed/36566985
http://dx.doi.org/10.1016/j.eprac.2022.12.012
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