Accuracy of continuous glucose monitoring system in emergency critically ill patients_West China Medical Journal

Authors：

LIANG Yin ^1,2,3 , GAO Yongli ^1,2,3 , ZHU Ling ^1,2,3 , LIU Yanhua ¹ ,  ZHANG Jianna ^1,2,3

1. Department of Emergency Medicine, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Disaster Medical Center, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Nursing Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHANG Jianna, Email: 9318696@qq.com

Keywords：

Continuous glucose monitoring system; blood glucose monitoring; critically ill patients; emergency department

DOI：

10.7507/1002-0179.202310045

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the accuracy of continuous glucose monitoring (CGM) system in emergency critically ill patients. Methods Critically ill patients admitted to the Intensive Care Unit of Department of Emergency Medicine, West China Hospital of Sichuan University between August 2022 and February 2023 were continuously enrolled. Blood glucose monitoring was performed using CGM system, while blood glucose in the patient’s fingertips was monitored every 4 hours. The correlation and consistency of blood glucose values between CGM system and fingertip glucose detection were compared. Results A total of 52 patients were included, and 1 504 matching blood glucose pairs were formed with fingertip blood glucose values. The overall correlation coefficient was 0.874 (P<0.001), the mean absolute relative difference was 14.50%, and the highest mean absolute relative difference (31.76%) was observed in the hypoglycemic range (<3.9 mmol/L). The percentage of CGM system blood glucose within ±15%, ±20% and ±30% of fingertip blood glucose was 56.65%, 75.56% and 94.75%, respectively. The intra-group correlation coefficient between CGM system blood glucose and fingertip blood glucose was 0.85 on the consistency test, and the Bland-Altman plot showed acceptable clinical accuracy. Conclusions The overall accuracy of the application of CGM system in critically ill patients is reasonable, but the accuracy in the range of low blood glucose values is poor. Whether the auxiliary use of CGM system can improve the blood glucose management of critically ill patients and reduce medical costs needs to be further studied.

1.	Gunst J, De Bruyn A, Van den Berghe G. Glucose control in the ICU. Curr Opin Anaesthesiol, 2019, 32(2): 156-162.
2.	Wu Z, Liu J, Zhang D, et al. Expert consensus on the glycemic management of critically ill patients. J Intensive Med, 2022, 2(3): 131-145.
3.	Chang MC, Hwang JM, Jeon JH, et al. Fasting plasma glucose level independently predicts the mortality of patients with coronavirus disease 2019 infection: a multicenter, retrospective cohort study. Endocrinol Metab (Seoul), 2020, 35(3): 595-601.
4.	Mukherjee JJ, Chatterjee PS, Saikia M, et al. Consensus recommendations for the management of hyperglycaemia in critically ill patients in the Indian setting. J Assoc Physicians India, 2014, 62(Suppl 7): 16-25.
5.	Nam K, Lee S. The indicators of glucose variability. J Anesth, 2021, 35(4): 600-601.
6.	Bergenstal RM, Beck RW, Close KL, et al. Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring. Diabetes Care, 2018, 41(11): 2275-2280.
7.	Moon SJ, Jung I, Park CY. Current advances of artificial pancreas systems: a comprehensive review of the clinical evidence. Diabetes Metab J, 2021, 45(6): 813-839.
8.	Perez-Guzman MC, Shang T, Zhang JY, et al. Continuous glucose monitoring in the hospital. Endocrinol Metab (Seoul), 2021, 36(2): 240-255.
9.	NICE-SUGAR Study Investigators, Finfer S, Chittock DR, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med, 2009, 360(13): 1283-1297.
10.	Bohé J, Abidi H, Brunot V, et al. Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial. Intensive Care Med, 2021, 47(11): 1271-1283.
11.	高鑫禹, 徐泽楷, 陈力群. 微创及无创血糖检测方法研究现状. 生物医学工程学杂志, 2023, 40(2): 365-372.
12.	中华医学会糖尿病学分会血糖监测学组. 中国扫描式葡萄糖监测技术临床应用专家共识. 中华糖尿病杂志, 2018, 10(11): 697-700.
13.	Alva S, Bailey T, Brazg R, et al. Accuracy of a 14-day factory-calibrated continuous glucose monitoring system with advanced algorithm in pediatric and adult population with diabetes. J Diabetes Sci Technol, 2022, 16(1): 70-77.
14.	楚晓婧, 李俊, 付艳芹, 等. 人体体质成分及血清生化指标对瞬感扫描式动态血糖监测仪准确性的影响研究. 中国全科医学, 2023, 26(35): 4433-4438.
15.	Huang W, Li S, Lu J, et al. Accuracy of the intermittently scanned continuous glucose monitoring system in critically ill patients: a prospective, multicenter, observational study. Endocrine, 2022, 78(3): 470-475.
16.	Perez-Guzman MC, Duggan E, Gibanica S, et al. Continuous glucose monitoring in the operating room and cardiac intensive care unit. Diabetes Care, 2021, 44(3): e50-e52.
17.	Carlsson CJ, Nørgaard K, Oxbøll AB, et al. Continuous glucose monitoring reveals perioperative hypoglycemia in most patients with diabetes undergoing major surgery: a prospective cohort study. Ann Surg, 2023, 277(4): 603-611.
18.	王素宁, 劳志刚, 吴昊, 等. 动态血糖监测联合胰岛素强化治疗高血糖危重患者的临床研究. 中国临床药理学杂志, 2018, 34(4): 414-416.

1. Gunst J, De Bruyn A, Van den Berghe G. Glucose control in the ICU. Curr Opin Anaesthesiol, 2019, 32(2): 156-162.
2. Wu Z, Liu J, Zhang D, et al. Expert consensus on the glycemic management of critically ill patients. J Intensive Med, 2022, 2(3): 131-145.
3. Chang MC, Hwang JM, Jeon JH, et al. Fasting plasma glucose level independently predicts the mortality of patients with coronavirus disease 2019 infection: a multicenter, retrospective cohort study. Endocrinol Metab (Seoul), 2020, 35(3): 595-601.
4. Mukherjee JJ, Chatterjee PS, Saikia M, et al. Consensus recommendations for the management of hyperglycaemia in critically ill patients in the Indian setting. J Assoc Physicians India, 2014, 62(Suppl 7): 16-25.
5. Nam K, Lee S. The indicators of glucose variability. J Anesth, 2021, 35(4): 600-601.
6. Bergenstal RM, Beck RW, Close KL, et al. Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring. Diabetes Care, 2018, 41(11): 2275-2280.
7. Moon SJ, Jung I, Park CY. Current advances of artificial pancreas systems: a comprehensive review of the clinical evidence. Diabetes Metab J, 2021, 45(6): 813-839.
8. Perez-Guzman MC, Shang T, Zhang JY, et al. Continuous glucose monitoring in the hospital. Endocrinol Metab (Seoul), 2021, 36(2): 240-255.
9. NICE-SUGAR Study Investigators, Finfer S, Chittock DR, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med, 2009, 360(13): 1283-1297.
10. Bohé J, Abidi H, Brunot V, et al. Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study-a randomized clinical trial. Intensive Care Med, 2021, 47(11): 1271-1283.
11. 高鑫禹, 徐泽楷, 陈力群. 微创及无创血糖检测方法研究现状. 生物医学工程学杂志, 2023, 40(2): 365-372.
12. 中华医学会糖尿病学分会血糖监测学组. 中国扫描式葡萄糖监测技术临床应用专家共识. 中华糖尿病杂志, 2018, 10(11): 697-700.
13. Alva S, Bailey T, Brazg R, et al. Accuracy of a 14-day factory-calibrated continuous glucose monitoring system with advanced algorithm in pediatric and adult population with diabetes. J Diabetes Sci Technol, 2022, 16(1): 70-77.
14. 楚晓婧, 李俊, 付艳芹, 等. 人体体质成分及血清生化指标对瞬感扫描式动态血糖监测仪准确性的影响研究. 中国全科医学, 2023, 26(35): 4433-4438.
15. Huang W, Li S, Lu J, et al. Accuracy of the intermittently scanned continuous glucose monitoring system in critically ill patients: a prospective, multicenter, observational study. Endocrine, 2022, 78(3): 470-475.
16. Perez-Guzman MC, Duggan E, Gibanica S, et al. Continuous glucose monitoring in the operating room and cardiac intensive care unit. Diabetes Care, 2021, 44(3): e50-e52.
17. Carlsson CJ, Nørgaard K, Oxbøll AB, et al. Continuous glucose monitoring reveals perioperative hypoglycemia in most patients with diabetes undergoing major surgery: a prospective cohort study. Ann Surg, 2023, 277(4): 603-611.
18. 王素宁, 劳志刚, 吴昊, 等. 动态血糖监测联合胰岛素强化治疗高血糖危重患者的临床研究. 中国临床药理学杂志, 2018, 34(4): 414-416.

West China Medical Journal

Latest ArticlesAccuracy of continuous glucose monitoring system in emergency critically ill patients

Abstract Full text Figures/Tables Video References Cited by

Format

Content