Impact of Hybrid Continuous Glucose Monitoring on Glycemic Control in a Medical Intensive Care Unit.

IF 4.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2026-09-04 DOI:10.1016/j.eprac.2026.08.021

Eileen R Faulds, Melanie Natasha Rayan, Molly McNett, Matthew Exline, Laureen Jones, Abigail Shoben, Chyongchiou J Lin, Brooke Lee, Amanie Rasul, Kathleen M Dungan

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引用次数: 0

Abstract

Objective: Continuous glucose monitoring (CGM) offers real-time glucose data that may improve dysglycemia detection in critically ill patients; however, evidence supporting its clinical effectiveness in the intensive care unit (ICU) remains limited. The objective of this study was to evaluate whether a nurse-driven hybrid continuous glucose monitoring plus point-of-care (POC) validation protocol improves glycemic outcomes compared with standard POC monitoring alone among medical ICU patients receiving continuous intravenous (IV) insulin.

Methods: In this single-center prospective intervention cohort study, 100 medical ICU (MICU) patients receiving continuous IV insulin were monitored using a hybrid CGM+POC protocol and compared with 100 matched historical controls. The primary outcome was % time in glucose range (70-180 mg/dL) during continuous IV insulin therapy, calculated using POC values (at least every 4 h) for between-group comparisons. Secondary outcomes included % time in additional glucose ranges, hyperglycemia (>250 and > 400 mg/dL), and hypoglycemia (<70 and < 54 mg/dL).

Results: Compared with controls, CGM-managed patients achieved an increased time in range (76% ± 18 vs 64% ± 21; P < .001) with persistent improvement after adjusting for confounders and marked reductions in severe hyperglycemia (>250 mg/dL: 6% ± 11 vs 17% ± 18; >300 mg/dL: 2.7 ± 0.6% vs 11.3 ± 1.4%; P < .001 for both). Hypoglycemic events were infrequent and similar between groups. A total of 3590 temporally matched CGM-POC pairs were available for analysis.

Conclusion: In this prospective MICU cohort, real-time hybrid CGM use improved glycemic control and reduced severe hyperglycemia without increasing hypoglycemia, supporting further evaluation of structured CGM integration in critical care practice.

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混合连续血糖监测对重症监护病房血糖控制的影响

目的：连续血糖监测（CGM）提供实时血糖数据，可改善危重患者血糖异常的检测；然而，支持其在重症监护病房（ICU）临床有效性的证据仍然有限。本研究的目的是评估护士驱动的混合连续血糖监测（CGM）加护理点（POC）验证方案与单独标准POC监测相比，是否能改善接受持续静脉注射（IV）胰岛素的ICU患者的血糖结局。方法：在这项单中心前瞻性干预队列研究中，采用CGM+POC混合方案监测100例持续静脉注射胰岛素的MICU患者，并与100例匹配的历史对照进行比较。主要终点是连续静脉注射胰岛素治疗期间血糖范围（70-180 mg/dL）的%时间，使用POC值（至少每4小时）计算，用于组间比较。次要结局包括额外血糖范围、高血糖（>50和bbb400 mg/dL）和低血糖(结果：与对照组相比，cgm管理的患者在范围内的时间增加(76%±18 vs 64%±21;p250 mg/dL: 6%±11 vs 17%±18;>300 mg/dL: 2.7±0.6% vs 11.3±1.4%；结论：在本前瞻性MICU队列中，实时混合CGM可改善血糖控制，降低严重高血糖，而不增加低血糖，支持进一步评估结构化CGM在重症监护实践中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.