Continuous glucose monitoring during intravenous insulin infusion treatment: Assessing accuracy to enable future clinical utility

IF 3.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Ray Wang, Mervyn Kyi, Brintha Krishnamoorthi, Ailie Connell, Cherie Chiang, Debra Renouf, Rahul Barmanray, Spiros Fourlanos
{"title":"Continuous glucose monitoring during intravenous insulin infusion treatment: Assessing accuracy to enable future clinical utility","authors":"Ray Wang,&nbsp;Mervyn Kyi,&nbsp;Brintha Krishnamoorthi,&nbsp;Ailie Connell,&nbsp;Cherie Chiang,&nbsp;Debra Renouf,&nbsp;Rahul Barmanray,&nbsp;Spiros Fourlanos","doi":"10.1111/dme.70076","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>Continuous glucose monitoring (CGM) during intravenous insulin infusions (IVII) could reduce blood glucose (BG) testing burden in hospital, however CGM accuracy concerns exist. We aimed to assess CGM accuracy during IVII.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This multi-centre observational study included adults with type 1 diabetes (T1D) who required IVII treatment during hospital admission whilst wearing their own CGM devices (Abbott FreeStyle Libre 2, Medtronic Guardian 3, Dexcom G6). IVII dose adjustments were performed based upon standard of care BG measures. Accuracy was assessed according to mean absolute relative difference (MARD) and Consensus error grid (CEG) analysis, using time-matched (±5 minutes) pairs of CGM glucose and reference BG (point-of-care [POC], blood gas [GAS]) obtained during IVII.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In total, 736 time-matched glucose pairs were obtained from 56 hospital admissions (52% with diabetic ketoacidosis; 32% requiring intensive care). Median IVII duration was 16 hours (IQR 7.2–28). Overall MARD was 12.5% (11.9% for CGM-POC pairs; 14.1% for CGM-GAS pairs). In CEG analysis, 99.0% of glucose pairs were within zones A/B. Based on local hospital IVII dose titration protocols for non-intensive care wards, if CGM measures had been used instead of POC, dose adjustments would have been the same in 77% of instances.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This real-world study of adults with T1D demonstrated high concordance of CGM measures with BG during IVII. The accuracy of CGM during IVII might enable its greater clinical utility when treating inpatients receiving IVII. More inpatient studies are required to validate the use of CGM during IVII.</p>\n </section>\n </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 9","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.70076","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dme.70076","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Aims

Continuous glucose monitoring (CGM) during intravenous insulin infusions (IVII) could reduce blood glucose (BG) testing burden in hospital, however CGM accuracy concerns exist. We aimed to assess CGM accuracy during IVII.

Methods

This multi-centre observational study included adults with type 1 diabetes (T1D) who required IVII treatment during hospital admission whilst wearing their own CGM devices (Abbott FreeStyle Libre 2, Medtronic Guardian 3, Dexcom G6). IVII dose adjustments were performed based upon standard of care BG measures. Accuracy was assessed according to mean absolute relative difference (MARD) and Consensus error grid (CEG) analysis, using time-matched (±5 minutes) pairs of CGM glucose and reference BG (point-of-care [POC], blood gas [GAS]) obtained during IVII.

Results

In total, 736 time-matched glucose pairs were obtained from 56 hospital admissions (52% with diabetic ketoacidosis; 32% requiring intensive care). Median IVII duration was 16 hours (IQR 7.2–28). Overall MARD was 12.5% (11.9% for CGM-POC pairs; 14.1% for CGM-GAS pairs). In CEG analysis, 99.0% of glucose pairs were within zones A/B. Based on local hospital IVII dose titration protocols for non-intensive care wards, if CGM measures had been used instead of POC, dose adjustments would have been the same in 77% of instances.

Conclusions

This real-world study of adults with T1D demonstrated high concordance of CGM measures with BG during IVII. The accuracy of CGM during IVII might enable its greater clinical utility when treating inpatients receiving IVII. More inpatient studies are required to validate the use of CGM during IVII.

Abstract Image

静脉注射胰岛素治疗期间持续血糖监测:评估准确性以实现未来临床应用。
目的:在静脉注射胰岛素(ivi)期间进行连续血糖监测(CGM)可以减轻医院血糖检测负担,但CGM的准确性存在问题。我们的目的是评估iv期CGM的准确性。方法:这项多中心观察性研究纳入了住院期间需要ivi治疗的1型糖尿病(T1D)成人,同时佩戴自己的CGM设备(雅培FreeStyle Libre 2、美敦力Guardian 3、Dexcom G6)。iv剂量调整是根据标准护理BG测量进行的。根据平均绝对相对差(MARD)和一致性误差网格(CEG)分析评估准确性,使用时间匹配(±5分钟)对的CGM葡萄糖和参考BG(护理点[POC],血气[gas])。结果:共获得时间匹配葡萄糖对736对,来自56例住院患者(52%为糖尿病酮症酸中毒;32%需要重症监护)。中位ivi持续时间为16小时(IQR为7.2-28)。总体MARD为12.5% (CGM-POC对为11.9%;CGM-GAS对为14.1%)。在CEG分析中,99.0%的葡萄糖对位于A/B区。根据当地医院非重症监护病房的ivi剂量滴定方案,如果使用CGM措施而不是POC, 77%的病例的剂量调整将是相同的。结论:这项对成人T1D患者的真实世界研究表明,在ivi期间,CGM测量值与BG高度一致。静脉注射期间CGM的准确性可能使其在治疗接受静脉注射的住院患者时具有更大的临床效用。需要更多的住院研究来验证在ivi期间使用CGM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信