Clinical application of real-time continuous glucose monitoring system during perioperative enteral nutrition therapy in esophageal cancer patients

Abstract

Abstract BACKGROUND/OBJECTIVES: The degree of blood glucose fluctuation between hyperglycemia and hypoglycemia during the perioperative period affects the recovery and prognosis of patients. Enteral nutrition (EN) support therapy can cause dramatic fluctuation of blood glucose, especially, the risk of hyperglycemia and death is higher in non-diabetic patients treated with EN. The aim of this study is to explore the clinical value of real-time continuous glucose monitoring (rt-CGM) system in blood glucose monitoring during perioperative enteral nutrition support therapy in patients with esophageal cancer. SUBJECTS/METHODS: Non-diabetic esophageal cancer patients who planned to receive postoperative enteral nutrition were enrolled. With self-monitoring of blood glucose (SMBG) value as the reference blood glucose, the accuracy of rt-CGM was evaluated by MARD value, correlation analysis, consistency analysis and Parkes and Clark error grid plot. Finally, paired t-tests were used to compare the differences in glycemic fluctuations between EN and non-EN days and slow and fast days. RESULTS: The total MARD value of rt-CGM system was 13.53%. There was a high correlation between interstitial glucose (IG) and fingertip capillary blood glucose (BG) (r = 0.925, P < 0.001). The proportion of consistency analysis of 15/15%, 20/20% and 30/30% was 58.45%, 84.71% and 99.65%, respectively. Parkes and Clark error grid showed that the proportion of A + B region was 100% and 99.94%, respectively. The fluctuation of blood glucose on EN days than non-EN days and on fast days than slow days was large, and the difference was statistically significant (P < 0.001). CONCLUSIONS: rt-CGM achieved clinical accuracy and can be used as a new option for glucose monitoring during perioperative EN therapy. The magnitude of glucose fluctuation during EN therapy remains large even in the perioperative population without a history of diabetes mellitus.