Clinical Use of Continuous Glucose Monitoring in Critically Ill Pediatric Patients with Diabetic Ketoacidosis
Authors' conclusion
The severity of DKA has a major effect on reducing the accuracy of the CGM, especially during the first several days in the intensive care unit. The reduced accuracy appears to be related to acidosis, as reflected in the serum bicarbonate levels.
Study context
- Population
- Pediatric patients with diabetic ketoacidosis (DKA) in the pediatric intensive care units (PICU); mean age 10.98 ± 4.20 years
- Participants
- 399 matched pairs
- Comparison
- Continuous glucose monitoring (CGM) vs point-of-care capillary glucose
- Medtronic Guardian Sensor 3n = 331
- Dexcom G6n = 41
- Abbott FreeStyle Libre 1n = 27
- Outcome
- Accuracy of CGM vs POC (MARD)
Performance
As reported in the abstract
MARD
| Outcome | Medtronic Guardian Sensor 3 | Dexcom G6 | Abbott FreeStyle Libre 1 |
|---|---|---|---|
| MARD | 13.40% | 11.12% | 11.33% |
- Overall mean absolute relative difference (MARD)
- 13.02%
- Surveillance error grid (SEG) zones A and B
- 98.5%
- Bland-Altman mean difference
- 15.5 mg/dL
- Pearson's correlation coefficient [r2]
- 0.76, P < 0.0001
Further findings
MARD by sensor change · MARD significantly lower without sensor change
P = 0.048
- MARD by sensor change: 3 patients in sensor change group
Correlation of serum bicarbonate with POC-CGM values
- Significant negative correlation (r)
- −0.34, P < 0.001
Original publication
Clinical Use of Continuous Glucose Monitoring in Critically Ill Pediatric Patients with Diabetic Ketoacidosis. Diabetes Technol Ther. Published 17 July 2023. doi:10.
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