CGMS in ICU
Trial question
What is the role of continuous glucose monitoring in critically ill patients with diabetes or stress-induced hyperglycemia?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
32.0% female
68.0% male
N = 96
96 patients (31 female, 65 male).
Inclusion criteria: critically ill patients with diabetes or stress-induced hyperglycemia.
Key exclusion criteria: uncorrected diabetic ketoacidosis; refractory shock; terminal cancer; pregnancy; current use of high-dose corticosteroids; end-stage metabolic organ dysfunction.
Interventions
N=48 continuous glucose monitoring (continuous glucose concentrations measured from interstitial fluid every 5 minutes and intermittent calibrations).
N=48 conventional PoC monitoring (blood glucose measured at least every 6 hours with capillary blood from the fingerstick by point-of-care monitoring glucose measurements).
Primary outcome
Death at day 28
20.8%
31.3%
31.3 %
23.5 %
15.7 %
7.8 %
0.0 %
Continuous glucose
monitoring
Conventional PoC
monitoring
No significant
difference ↔
No significant difference in death at day 28 (20.8% vs. 31.3%; RR 0.66, 95% CI -0.46 to 1.78).
Secondary outcomes
No significant difference in death at day 90 (25% vs. 35.4%; RR 0.71, 95% CI -0.54 to 1.96).
No significant difference in hospital length of stay (24 days vs. 15 days; AD 9 days, 95% CI -0.75 to 18.75).
No significant difference in vasopressor use (50% vs. 60.4%; RR 0.83, 95% CI -0.76 to 2.42).
Conclusion
In critically ill patients with diabetes or stress-induced hyperglycemia, continuous glucose monitoring was not superior to conventional PoC monitoring with respect to death at day 28.
Reference
Chen Chu, Jian Li, XiaoDong Yang et al. Continuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial. J Crit Care. 2024 Dec:84:154894.
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