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Review
. 2016 Nov 1;10(6):1372-1381.
doi: 10.1177/1932296816648713. Print 2016 Nov.

Glucose Control in the ICU: A Continuing Story

Jean-Charles Preiser  1 , J Geoffrey Chase  2 , Roman Hovorka  3 , Jeffrey I Joseph  4 , James S Krinsley  5 , Christophe De Block  6 , Thomas Desaive  7 , Luc Foubert  8 , Pierre Kalfon  9 , Ulrike Pielmeier  10 , Tom Van Herpe  11 , Jan Wernerman  12
Affiliations
Review

Glucose Control in the ICU: A Continuing Story

Jean-Charles Preiser et al. J Diabetes Sci Technol. .

Abstract

In the present era of near-continuous glucose monitoring (CGM) and automated therapeutic closed-loop systems, measures of accuracy and of quality of glucose control need to be standardized for licensing authorities and to enable comparisons across studies and devices. Adequately powered, good quality, randomized, controlled studies are needed to assess the impact of different CGM devices on the quality of glucose control, workload, and costs. The additional effects of continuing glucose control on the general floor after the ICU stay also need to be investigated. Current algorithms need to be adapted and validated for CGM, including effects on glucose variability and workload. Improved collaboration within the industry needs to be encouraged because no single company produces all the necessary components for an automated closed-loop system. Combining glucose measurement with measurement of other variables in 1 sensor may help make this approach more financially viable.

Keywords: continuous glucose control; diabetes; intensive care; time in band.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JCP is a consultant for Edwards, Medtronic and Optiscan. JGC has consulted with Medtronic. RH has received speaker honoraria from Minimed Medtronic, Eli Lilly, BBraun, and Novo Nordisk, served on advisory panels for Eli Lilly, Novo Nordisk and Merck, received license fees from BBraun and Medtronic, and served as a consultant to BBraun. JIJ has received research funding and/or has been a consultant for Edwards Lifesciences, Medtronic Diabetes, GluMetrics, Glysure, Roche Diagnostics, Thermalin Diabetes, and Echo Therapeutics. JSK is a consultant for Edwards, Medtronic, Roche Diagnostics and Optiscan. CD is a consultant for Abbott, A. Menarini Diagnostics, Medtronic, Roche Diagnostics. LF has received speaking fees from Edwards Lifesciences.

Figures

Figure 1.
Figure 1.
Glucose profiles (median and interquartile range) during closed-loop (pink) and manual sliding scale (gray) glucose control. Reproduced from Leelarathna et al.
See this image and copyright information in PMC

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