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. 2021 May;15(3):607-614.
doi: 10.1177/1932296820985263. Epub 2021 Jan 12.

Outcomes and Healthcare Provider Perceptions of Real-Time Continuous Glucose Monitoring (rtCGM) in Patients With Diabetes and COVID-19 Admitted to the ICU

Kenneth W Chow  1 , Danielle J Kelly  1 , Mary C Rieff  1 , Patricia A Skala  1 , Igor Kravets  1 , Marina M Charitou  1 , Eric J Morley  1 , Rajarsi Gupta  1 , Joshua D Miller  1
Affiliations

Outcomes and Healthcare Provider Perceptions of Real-Time Continuous Glucose Monitoring (rtCGM) in Patients With Diabetes and COVID-19 Admitted to the ICU

Kenneth W Chow et al. J Diabetes Sci Technol. 2021 May.

Abstract

Objective: We assessed the clinical utility and accuracy of real-time continuous glucose monitoring (rtCGM) (Dexcom G6) in managing diabetes patients with severe COVID-19 infection following admission to the intensive care unit (ICU).

Methods: We present retrospective analysis of masked rtCGM in 30 patients with severe COVID-19. rtCGM was used during the first 24 hours for comparison with arterial-line point of care (POC) values, where clinicians utilized rtCGM data to adjust insulin therapy in patients if rtCGM values were within 20% of point-of-care (POC) values during the masked period. An investigator-developed survey was administered to assess nursing staff (n = 66) perceptions regarding the use of rtCGM in the ICU.

Results: rtCGM data were used to adjust insulin therapy in 30 patients. Discordance between rtCGM and POC glucose values were observed in 11 patients but the differences were not considered clinically significant. Mean sensor glucose decreased from 235.7 ± 42.1 mg/dL (13.1 ± 2.1 mmol/L) to 202.7 ± 37.6 mg/dL (11.1 ± 2.1 mmol/L) with rtCGM management. Improvements in mean sensor glucose were observed in 77% of patients (n = 23) with concomitant reductions in daily POC measurements in 50% of patients (n = 15) with rtCGM management. The majority (63%) of nurses reported that rtCGM was helpful for improving care for patients with diabetes patients during the COVID-19 pandemic, and 49% indicated that rtCGM reduced their use of personal protective equipment (PPE).

Conclusions: Our findings provide a strong rationale to increase clinician awareness for the adoption and implementation of rtCGM systems in the ICU. Additional studies are needed to further understand the utility of rtCGM in critically ill patients and other clinical care settings.

Keywords: COVID-19; cardiac arrest; hyperglycemia; rtCGM; type 2 diabetes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JM reports receiving consulting fees from Medtronic Diabetes and Ascensia Diabetes Care. MC receives compensation for participation in the Dexcom speakers bureau.

Figures

Figure 1.
Figure 1.
Concordance between rtCGM and arterial-line POC values in selected patients. rtCGM: real-time continuous glucose monitoring.
Figure 2.
Figure 2.
Overall change in mean sensor glucose level during rtCGM management. rtCGM: real-time continuous glucose monitoring.
See this image and copyright information in PMC

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References

    1. Richardson S, Hirsch JS, Narasimhan M, et al.. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area. JAMA. 2020;323(20):2052-2059. - PMC - PubMed
    1. Bhatraju PK, Ghassemieh BJ, Nichols M, et al.. Covid-19 in critically ill patients in the seattle region — case series. N Engl J Med. 2020;382:2012-2022. - PMC - PubMed
    1. Guo W, Li M, Dong Y, et al.. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020;e3319. - PMC - PubMed
    1. Bruce Bode B, Garrett V, Messler J, et al.. Glycemic characteristics and clinical outcomes of COVID-19 patients hospitalized in the United States. J Diabetes Sci Technol. 2020;14(4):813-821. - PMC - PubMed
    1. Fadini GP, Moieri ML, Longato E, Avogaro A. Prevalence and impact of diabetes among people infected with SARS-CoV-2. J Endocrinol Invest. 2020;43(6):867-869. - PMC - PubMed

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