Continuous Glucose Monitoring in the Intensive Care Unit During the COVID-19 Pandemic
Author(s) -
Shivani Agarwal,
Justin Mathew,
Georgia M. Davis,
Alethea Shephardson,
Ann Marie LeVine,
Rita J. Louard,
Agustina Urrutia,
M. Citlalli PerezGuzman,
Guillermo E. Umpierrez,
Limin Peng,
Francisco J. Pasquel
Publication year - 2020
Publication title -
diabetes care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.636
H-Index - 363
eISSN - 1935-5548
pISSN - 0149-5992
DOI - 10.2337/dc20-2219
Subject(s) - medicine , continuous glucose monitoring , intensive care unit , covid-19 , pandemic , glycemic , diabetes mellitus , intensive care medicine , critically ill , emergency medicine , severity of illness , intensive care , insulin , disease , endocrinology , infectious disease (medical specialty) , virology , outbreak
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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