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Continuous Glucose Monitoring in Pediatric Diabetic Ketoacidosis

Thomas Pott1,2,3, Jose Jimenez-Vega2,4, Jessica Parker5

  • 1Division of Pediatric Critical Care, Helen DeVos Children's Hospital, Spectrum Health, Grand Rapids, MI, USA.

Journal of Diabetes Science and Technology
|November 23, 2022
PubMed

Insights

Real-time continuous glucose monitoring (rtCGM) is feasible and reliable for children hospitalized with diabetic ketoacidosis (DKA). This technology accurately tracks glucose levels during DKA treatment, aiding in pediatric intensive care.

Area of Science:

  • Pediatric Endocrinology
  • Medical Technology Assessment
  • Diabetes Management

Background:

  • Real-time continuous glucose monitoring (rtCGM) improves glycemic control in type 1 diabetes (T1D) but its use in pediatric DKA is understudied.
  • Diabetic ketoacidosis (DKA) is a serious complication of T1D requiring intensive management.

Purpose of the Study:

  • To assess the accuracy, reliability, and feasibility of rtCGM in pediatric patients with DKA.
  • To compare rtCGM glucose readings with point-of-care (POC) capillary and serum glucose values.
  • To evaluate the relationship between rtCGM accuracy and the degree of acidosis.

Main Methods:

  • Prospective, single-arm, single-center study involving 35 hospitalized children with DKA.
  • Comparison of rtCGM values against POC capillary and serum glucose measurements.
  • Accuracy assessed using Clarke Error Grid (CEG) analysis.

Main Results:

  • High accuracy of rtCGM was observed, with 95.4% of paired values within clinically acceptable zones (A+B) compared to POC capillary glucose and 95.6% compared to serum glucose.
  • Mean length of hospital stay was 1.32 days.
  • Acidosis severity, indicated by serum bicarbonate levels, did not significantly impact rtCGM accuracy.

Conclusions:

  • rtCGM is a feasible and reliable tool for monitoring glucose levels in pediatric patients during inpatient DKA treatment.
  • The findings support the expanded use of rtCGM in pediatric intensive care settings for DKA management.
Abstract

Keywords:
DKAcontinuous glucose monitoringdiabetic ketoacidosispediatrictype 1 diabetes

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