Reliability of Inpatient Continuous Glucose Monitoring (CGM): Comparison to Standard of Care
Authors' conclusion
These results suggest that the use of inpatient CGM arrives at similar correction insulin dosing. The routine use of CGM for inpatients would consistently underestimate the BG compared with POC BG and could aid in minimizing and predicting hypoglycemia in the hospital setting. Our data support that the model of adoption of real-time inpatient CGM technology is anticipated to have significant impact in the clinical setting in efforts to maintain adequate glycemic control targeting BG 140-180 mg/dL while minimizing the frequency of hypoglycemic events.
Study context
- Population
- Hospitalized patients with hyperglycemia/diabetes mellitus (DM) treated with basal bolus insulin or intravenous insulin (IVI)
- Participants
- 20 vs 16
- Comparison
- Inpatient CGM vs standard point of care (POC) blood glucose (BG) measurements
- BBTn = 20
- IVIn = 16
- Outcome
- Comparability of CGM vs POC BG (mean absolute relative difference)
Methodological detailsblinded (professional) CGM, CGM data not available in real time
- Blinded (professional) CGM
- CGM data not available in real time
Main finding
As reported in the abstract
Mean absolute relative difference, CGM vs POC BG BBT mean 24.6% (SD 8.1) · IVI mean 19.6% (SD 9.4)
Median
- Between IVI and BBT: P = 0.10 — means not different (Wilcoxon two-sample test)
- Between IVI and BBT: P = 0.015 — medians different (Wilcoxon two-sample test)
- Overall mean absolute relative difference (both groups)
- 22.3% (SD, 9.0); median 20.0%
Further findings
CGM minus POC BG (CGM lower in majority of paired values)
- CGM minus POC BG (CGM lower in majority of paired values) — Agreement of glucose results (Bland-Altman)
- 83%
Correction insulin dose, CGM vs POC BG
- Absolute difference in insulin dose, BBT (1142 paired values)
- 1.34 units
- Absolute difference in insulin dose, IVI (300 paired values)
- 0.74 units
Earlier hypoglycemia detection by CGM vs POC BG
- Average lead time of CGM detection
- 3 hours and 34 minutes
- Lead time in severe nocturnal hypoglycemia (POC BG <54 mg/dL)
- up to 3 hours and 42 minutes
- If used in real time
Safety
- BBT patients with hypoglycemic event (POC BG <70 mg/dL)
- About a third
- Severe nocturnal hypoglycemia (POC BG <54 mg/dL)
- 2 participants
Original publication
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