Accuracy of continuous glucose monitoring systems in intensive care unit patients: a scoping review

Christian G. Nielsen*, Milda Grigonyte-Daraskeviciene, Mikkel T. Olsen, Morten H. Møller, Kirsten Nørgaard, Anders Perner, Johan Mårtensson, Ulrik Pedersen-Bjergaard, Peter L. Kristensen, Morten H. Bestle

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

Abstract

Purpose: Glycemic control poses a challenge in intensive care unit (ICU) patients and dysglycemia is associated with poor outcomes. Continuous glucose monitoring (CGM) has been successfully implemented in the type 1 diabetes out-patient setting and renewed interest has been directed into the transition of CGM into the ICU. This scoping review aimed to provide an overview of CGM accuracy in ICU patients to inform future research and CGM implementation. Methods: We systematically searched PubMed and EMBASE between 5th of December 2023 and 21st of May 2024 and reported findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for scoping reviews (PRISMA-ScR). We assessed studies reporting the accuracy of CGM in the ICU and report study characteristics and accuracy outcomes. Results: We identified 2133 studies, of which 96 were included. Most studies were observational (91.7%), conducted in adult patients (74%), in mixed ICUs (47.9%), from 2014 and onward, and assessed subcutaneous CGM systems (80%) using arterial blood samples as reference test (40.6%). Half of the studies (56.3%) mention the use of a prespecified reference test protocol. The mean absolute relative difference (MARD) ranged from 6.6 to 30.5% for all subcutaneous CGM studies. For newer factory calibrated CGM, MARD ranged from 9.7 to 20.6%. MARD for intravenous CGM was 5–14.2% and 6.4–13% for intraarterial CGM. Conclusions: In this scoping review of CGM accuracy in the ICU, we found great diversity in accuracy reporting. Accuracy varied depending on CGM and comparator, and may be better for intravascular CGM and potentially lower during hypoglycemia.

Original languageEnglish
JournalIntensive Care Medicine
Volume50
Issue number12
Pages (from-to)2005-2018
Number of pages14
ISSN0342-4642
DOIs
Publication statusPublished - 2024

Bibliographical note

Publisher Copyright:
© Springer-Verlag GmbH Germany, part of Springer Nature 2024.

Keywords

  • CGM
  • Continuous Glucose Monitoring
  • Glucose Management
  • ICU
  • Intensive Care Unit

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