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. 2023 Sep;17(5):1252-1255.
doi: 10.1177/19322968221076562. Epub 2022 Feb 7.

Accuracy of Continuous Glucose Monitors for Inpatient Diabetes Management

Jordan J Wright  1 , Alexander J Williams  1 , Sally B Friedman  1 , Rita G Weaver  1 , Jonathan M Williams  1 , Elizabeth Hodge  1 , Michael Fowler  1 , Shichun Bao  1
Affiliations

Accuracy of Continuous Glucose Monitors for Inpatient Diabetes Management

Jordan J Wright et al. J Diabetes Sci Technol. 2023 Sep.

Abstract

Introduction: In hospitalized patients, continuous glucose monitoring (CGM) may improve glycemic control, prevent hypoglycemic events, and reduce staff workload compared with point-of-care (POC) capillary glucose monitoring.

Methods: To evaluate CGM accuracy and safety of use in the inpatient setting, two versions of CGM sensors were placed on 43 and 34 adult patients with diabetes admitted to non-intensive care unit (ICU) medical wards, respectively. CGM accuracy relative to POC and safety of use were measured by calculating mean absolute relative difference (MARD) and by Clarke Error Grid (CEG) analysis.

Results: CGM version 2 had improved accuracy compared with CGM version 1 with MARD 17.7 compared with 21.4%. CGM accuracy did not change with POC value or with time of sensor wear. On CEG, 98.8% of paired values fell within acceptable zones A and B.

Conclusion: Despite reduced accuracy compared with the outpatient setting, both versions of CGMs had acceptable safety profiles in the inpatient setting.

Keywords: continuous glucose monitor (CGM); diabetes technology; inpatient diabetes management; type 1 diabetes (T1DM); type 2 diabetes (T2DM).

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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: SB has received research funding, paid to her institution, from Dexcom, Novo Nordisk, Mylan, AstraZeneca, and Bristol Myers Squibb. JJW, AJW, SBF, RGW, EH, MF, and JMW report no relevant conflicts of interest. CGM sensors and receivers were provided without restriction by Abbott.

Figures

Figure 1.
Figure 1.
CGM-1 and CGM-2 accuracy in adult hospitalized patients. (a-b) CGM relative difference compared with POC capillary blood glucose remains unchanged regardless of POC value and length of time on sensor. Points represent individual paired CGM and POC values. Line represents slope of the mean of individual values. (c) 98.8% of values fall in acceptable zones A and B of the Clarke Error Grid. (d) MARD variability between individual participants is high; points represent individual participants. n = 43 (CGM-1) and 34 (CGM-2) participants with a total of 676 paired glucose values. Abbreviations: CGM, continuous glucose monitoring; POC, point-of-care; MARD, mean absolute relative difference.
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