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Review
. 2023 Nov;29(11):919-927.
doi: 10.1016/j.eprac.2023.06.007. Epub 2023 Jun 25.

Accuracy and Potential Interferences of Continuous Glucose Monitoring Sensors in the Hospital

Virginia Bellido  1 , Guido Freckman  2 , Antonio Pérez  3 , Rodolfo J Galindo  4
Affiliations
Review

Accuracy and Potential Interferences of Continuous Glucose Monitoring Sensors in the Hospital

Virginia Bellido et al. Endocr Pract. 2023 Nov.

Abstract

For years, the standard of care for monitoring dysglycemia in hospitalized patients was capillary blood glucose (CBG) testing with point-of-care glucose meters. Recently, there has been a revolution in novel factory-calibrated continuous glucose monitoring (CGM) systems. Newer CGMs are smaller and less expensive, have improved accuracy and longer wear time, and do not require fingerstick CBG for calibration, resulting in increased utilization in ambulatory settings. Consequently, hospitals have noticed increased usability of CGMs among hospitalized patients and expect a progressive continued increase. During the COVID-19 pandemic, there was a critical need for innovative approaches to glycemic monitoring, with several pilot implementation projects using CGM in the intensive care unit and non-intensive care unit settings, further boosting the evidence in this area. Hence, recent guidelines have provided recommendations for the use of CGM in specific hospital scenarios and highlighted the potential of CGM to overcome CBG limitations for glucose monitoring in the inpatient setting. In this review, we provide the following: 1) an up-to-date review of the accuracy of the newer CGMs in hospitalized patients, 2) a discussion of standards for CGM accuracy metrics, 3) a contemporary overview of potential interferences that may cause inaccuracies or poor CGM performance, and 4) required steps for full regulatory approval of CGMs in the hospital and future research steps to advance the field forward.

Keywords: Accuracy; CGM; glucose monitoring; inpatient diabetes.

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Conflict of interest statement

Disclosure V.B. has served as a consultant for or received research support, lecture fees, or travel reimbursement from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Esteve, Janssen, Merck, Mundipharma, Novartis, Novo Nordisk, Roche, and Sanofi. G.F. is the general manager and medical director of the Institute for Diabetes Technology (IfDT), Ulm, Germany, which carries out clinical studies, eg, with medical devices for diabetes therapy on its own initiative and on behalf of various companies. G.F./IDT received research support, speakers’ honoraria, or consulting fees from Abbott, Ascensia, Berlin Chemie, Boydsense, Dexcom, Lilly, Metronom, Medtronic, Menarini, MySugr, Novo Nordisk, Pharamsens, Roche, Sanofi, and Terumo outside the scope of this work. A.P. has served as a consultant for or received research support, lecture fees, or travel reimbursement from Sanofi Aventis, Almirall, Novo Nordisk, Eli Lilly, MSD, Abbott, Boehringer Ingelheim, Esteve, Gilead, Novartis, Amgen, Menarini, Amarin, Daiichi Sankyo, and Astra Zeneca. R.J.G. received unrestricted research support (to Emory University) from Novo Nordisk, Dexcom, and Eli Lilly and consulting/personal fees from Abbott Diabetes Care, Dexcom, Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Bayer, Pfizer, and Weight Watchers, outside the scope of this work.

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