Determinants of Continuous Glucose Monitoring Accuracy in Critically Ill Patients Requiring Mechanical Ventilation and Vasopressor Support
Authors' conclusion
In critically ill patients receiving mechanical ventilation and vasopressor therapy, CGM accuracy improves substantially with increasing sensor wear time and is independently associated with arterial pH.
Study context
- Population
- Critically ill adults receiving IV insulin, mechanical ventilation and vasopressor therapy; Continuous glucose monitoring (CGM) with Dexcom G6®2,946 paired arterial blood glucose (ABG)–CGM values
- Participants
- 40 adults
- Primary endpoint
- Percentage absolute relative difference (ARD) between CGM and arterial blood glucose
Methodological detailsmultivariable generalized linear mixed models with patient-level random intercepts, B-splines for continuous covariates
- Multivariable generalized linear mixed models with patient-level random intercepts
- B-splines for continuous covariates
Primary result
As reported in the abstract
ARD
- Median absolute relative difference (ARD) (IQR 5.2-18.8)
- 10.8%
- Mean ARD
- 12.7 % (95% CI 10.7-15.3)
- Sensor wear time independently associated with ARD and both categorical accuracy metrics
- P < 0.001
- pH independently associated with ARD and both categorical accuracy metrics
- P ≤ 0.02
- Each 0.1-unit increase in pH: higher ARD (linear-term sensitivity analysis; P = 0.009)
- 1.5 percentage-point
Secondary outcomes
Readings meeting ISO 15197:2013 and CLSI POCT12-A3 criteria
- Readings meeting ISO criteria
- 64.5%
- Readings meeting CLSI criteria
- 56.0%
- Each 0.1-unit increase in pH: lower odds of meeting CLSI criteria (linear-term sensitivity analysis; P = 0.001)
- 32%
- Noradrenaline-equivalent (NE)-dose independently associated with ISO-defined accuracy
- P = 0.006
- ABG independently associated with ISO-defined accuracy
- P < 0.001
- Probability of meeting ISO/CLSI criteria increased during first 50 h after insertion, then stabilized
- Spline analyses suggested reduced accuracy at higher NE-doses (>0.6 µg/kg/min) and lower ABG (<5 mmol/L [<90 mg/dL]); limited observations in these ranges
Original publication
Determinants of Continuous Glucose Monitoring Accuracy in Critically Ill Patients Requiring Mechanical Ventilation and Vasopressor Support. Diabetes Technol Ther. Published 20 August 2026. doi:10.
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