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. 2025 Jul;69(6):e70086.
doi: 10.1111/aas.70086.

Effects of Continuous Versus Intermittent Glucose Monitoring in Intensive Care Unit Patients: Protocol for a Systematic Review With Meta-Analysis

Christian Gantzel Nielsen  1 , Milda Grigonyte-Daraskeviciene  2 , Mathias Maagaard Blem  1 , Peter Lommer Kristensen  3   4 , Ulrik Pedersen-Bjergaard  3   4 , Mikkel Thor Olsen  5 , Kirsten Nørgaard  4   5 , Anders Perner  2   4 , Johan Mårtensson  6   7 , Morten Hylander Møller  2   4 , Morten Heiberg Bestle  1   4
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Effects of Continuous Versus Intermittent Glucose Monitoring in Intensive Care Unit Patients: Protocol for a Systematic Review With Meta-Analysis

Christian Gantzel Nielsen et al. Acta Anaesthesiol Scand. 2025 Jul.

Abstract

Background: Glucose management in intensive care unit (ICU) patients is challenging, and dysglycemia is associated with increased morbidity and mortality. Continuous glucose monitoring (CGM) could be a potential tool to improve clinical and glycemic outcomes compared with current practice which relies on intermittent glucose measurements.

Aim: The aim of this systematic review and meta-analysis is to assess the effects of CGM compared with point of care (POC) glucose measurements on clinical patient-important and glycemic outcomes in ICU patients.

Methods: This protocol is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline. We will include all randomized clinical trials in ICU patients. The primary outcome is mortality at the longest follow-up, and the main-secondary outcome is the number of hypoglycemic events. Additional outcomes include both patient-important and glycemic outcomes. We will systematically search: PubMed, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Web of Science Core Collection. We will assess risk of bias using the Cochrane Risk of Bias 2 tool and conduct a Trial Sequential Analysis for the primary and main-secondary outcome. Clinical heterogeneity will be assessed using the Clinical Diversity in meta-analyses tool, and the certainty of evidence will be assessed using the Grading of Recommendation Assessment, Development, and Evaluation approach.

Discussion: This systematic review with meta-analysis will provide an updated overview and synthesis of the effect of CGM versus POC glucose monitoring to inform clinical practice and future trials.

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Conflict of interest statement

UPB has served on advisory boards for Novo Nordisk, Sanofi‐Aventis, and Vertex and has received lecture fees from Novo Nordisk and Sanofi‐Aventis. MTO has received speaker fees from Novo Nordisk and serves on the scientific advisory board for decide Clinical Software GmbH (GlucoTab). KN serves as an adviser to Medtronic, Abbott, Convatec and Novo Nordisk; owns shares in Novo Nordisk; has received research grants to the institution from Novo Nordisk, Zealand Pharma, Dexcom and Medtronic; and has received fees for speaking from Medtronic, and Novo Nordisk. JM has received research support from DexCom, Inc. outside the submitted work. MGD, AP and MHM are affiliated with Dept. of Intensive Care, Rigshospitalet, which receives funds for research from the Novo Nordisk Foundation.

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