Continuous Glucose Monitoring in Intensive Care Unit Patients with Diabetes: Insights and Outcomes from a Single-center Study in India

Abstract

Abstract Introduction: The use of continuous glucose monitoring (CGM) for in-hospital glucose control has been widely studied. However, its application in intensive care unit (ICU) settings is debatable owing to its perceived limitations. In ICU patients with diabetes, glycemic excursions, including frequent hypoglycemic episodes, are more prevalent. This retrospective study was undertaken to evaluate the utility of CGM in the management of diabetes patients admitted to the ICU. Methods: We collected data of patients with diabetes mellitus who were admitted to the ICU at our institution and were advised CGM by the intensivist. A retrospective analysis was conducted, examining demographic, clinical, and laboratory data, along with glucose meter readings and CGM data. The results are presented as numbers, percentages, or median values, as appropriate. Results: Out of 65 patients in the ICU, the median values of percentage time in range, time below range, and time above range were 59%, 2%, and 36%, respectively. The median HbA1C and capillary glucose on admission were 8.8% and 246 mg/dl, respectively. During the ICU stay, the CGM derived average glucose level was 167 mg/dl (percent coefficient of variation [%CV] =25.96) and the glucose management indicator was 7%. In total, 65 episodes of hypoglycemia were detected, all confirmed by capillary glucose tests. A total of 27 patients experienced hypoglycemia, of which 12 had nocturnal hypoglycemia. Conclusion: The use of CGM in the ICU improved glycemic control and helped to detect hypoglycemia, particularly nocturnal with acceptably low glycemic variability as measured by percentage CV. Further studies are required to corroborate and confirm these findings.