Continuous glucose monitoring in critically ill adult patients: results of a pilot study in Greece

Athena D. Myrou; Triantafyllos P. Didaggelos; Hellen G. Geka; Evangellos M. Pertsas; Dimitrios K. Ginas; Matthaios B. Didaggelos; Theodoros K. Aslanidis; Konstantinos G. Barmpagiannos; Andreas I. Theodoridis; Styliani A. Spanou; Evelina E. Kotzakioulafi; Christos G. Savopoulos

doi:10.18203/2320-6012.ijrms20243685

Authors

Athena D. Myrou Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Triantafyllos P. Didaggelos Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Hellen G. Geka Intensive Care Unit, AHEPA University General Hospital, Thessaloniki, Greece
Evangellos M. Pertsas Department of Anesthesia and Intensive Care, AHEPA University General Hospital, Thessaloniki, Greece
Dimitrios K. Ginas Department of Anesthesia and Intensive Care, AHEPA University General Hospital, Thessaloniki, Greece
Matthaios B. Didaggelos Cardiology Department, AHEPA University General Hospital, Thessaloniki, Greece
Theodoros K. Aslanidis Intensive Care Unit, “Agios Pavlos” General Hospital, Thessaloniki, Greece
Konstantinos G. Barmpagiannos Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Andreas I. Theodoridis Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Styliani A. Spanou Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Evelina E. Kotzakioulafi Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece
Christos G. Savopoulos Department of Internal Medicine, AHEPA University General Hospital, Thessaloniki, Greece

DOI:

https://doi.org/10.18203/2320-6012.ijrms20243685

Keywords:

Type 2 diabetes, Continuous glucose monitoring, Intensive care unit

Abstract

Background: Continuous glucose monitoring has emerged as a promising tool in managing glycemic control for patients with type 2 diabetes admitted to the intensive care unit. This paper provides a comprehensive review of the potential benefits, challenges, and implications associated with continuous glucose monitoring utilization in intensive care unit settings for type 2 diabetic patients.

Methods: In a prospective observational study continuous glucose monitoring systems were applied in adult intensive care unit patients in two centers. Eighty patients were randomly assigned into 2 groups: one with continuous glucose monitoring system one with standard glucose monitoring, previous medical history, reason for intensive care unit admission, demographic characteristics and laboratory parameters were recorded.

Results: Recordings from six patients were excluded from analysis. Patients on home insulin and tablet combination therapy had worse glycemic control than subjects on insulin monotherapy or oral tablets alone. There was no difference in the glycemic profile of patients before and within the unit between those who were Covid-19 positive and those who had different reasons for admission to the unit. However, obese subjects had significantly worse glycemic control. Glucose measurements with continuous glucose monitoring and standard method were in almost total agreement.

Conclusions: While continuous glucose monitoring benefits may allow a more personalized therapeutic strategy, further research is necessary to evaluate the cost-effectiveness and long-term implications of continuous glucose monitoring implementation in the intensive care unit setting.

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References

Sun MT, Li IC, Lin WS, Lin GM. Pros and cons of continuous glucose monitoring in the intensive care unit. World J Clin Cases. 2021;9(29):8666-70.

Todi S. Glycemic control in critically ill: A moving target. Indian J Crit Care Med. 2014;18(4):229-33.

Alhatemi G, Aldiwani H, Alhatemi R, Hussein M, Mahdai S, Seyoum B. Glycemic control in the critically ill: Less is more. Cleve Clin J Med. 2022;89(4):191-9.

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Glycemic Targets: Standards of Care in Diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S97-S110.

Chee F, Fernando T, van Heerden PV. Closed-loop glucose control in critically ill patients using continuous glucose monitoring system (CGMS) in real time. IEEE Tran INF Technol Biomed. 2003;7(1):43-53.

Krinsley JS, Chase JG, Gunst J, Martensson J, Schultz MJ, Taccone FS, et al. Continuous glucose monitoring in the ICU: clinical considerations and consensus. Crit Care. 2017;21(1):197.

Beardsall K, Thomson L, Guy C, Iglesias-Platas I, van Weissenbruch MM, Bond S, et al. Real-time continuous glucose monitoring in preterm infants (REACT): an international, open label, randomised controlled trial. Lancet Child Adolesc Health. 2021;5(4):265-273.

Tingsarat W, Buranasupkajorn P, Khovidhunkit W, Boonchaya-Anant P, Laichuthai N. The accuracy of continuous glucose monitoring in the medical intensive care unit. J Diabetes Sci Technol. 2022;16(6):1550-4.

Perez-Guzman MC, Duggan E, Gibanica S, Cardona S, Corujo-Rodriguez A, Faloye A, et al. Continuous glucose monitoring in the operating room and cardiac intensive care unit. Diabetes Care. 2021;44(3):e50-2.

Agarwal S, Mathew J, Davis GM, Shephardson A, Levine A, Louard R, et al. Continuous glucose monitoring in the intensive care unit during the COVID-19 pandemic. Diabetes Care. 2021;44(3):847-9.

Faulds ER, Boutsicaris A, Sumner L, Jones L, McNett M, Smetana KS, et al. Use of continuous glucose monitor in critically ill COVID-19 patients requiring insulin infusion: an observational study. J Clin Endocrinol Metab. 2021;106(10):e4007-16.

Kotzapanagiotou E, Tsotridou E, Volakli E, Dimitriadou M, Chochliourou E, Kalamitsou S, et al. Evaluation of continuous flash glucose monitoring in a pediatric ICU setting. J Clin Monit Comput. 2020;34(4):843-52.