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In this study, clinicians continuously monitored blood glucose in 11 patients with confirmed COVID-19 and glucose variability. Data showed that real-time continuous glucose monitoring (rtCGM) in critically ill patients is feasible and accurate and resulted in reduced point-of-care testing frequency in patients on continuous insulin infusion (n=8).
The use of rtCGM in critically ill patients can have a positive impact in the management of patients with diabetes and COVID-19 infection.
This abstract is available on the publisher's site.
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.
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.
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.