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Continuous Glucose Monitoring in Hospitalized Adults With Diabetic Ketoacidosis: A Prospective Open-Label Pilot Study
Magdalena M Bogun1, Chunhui Wang2, Paul A Kurlansky2
1Department of Medicine, Columbia University, New York, NY, USA.
Journal of Diabetes Science and Technology
|February 5, 2025
Summary
Continuous glucose monitoring (CGM) is effective for managing diabetic ketoacidosis (DKA) in hospitalized adults. This pilot study found CGM reliable during insulin treatment and after DKA resolution, supporting its use in acute care settings.
Area of Science:
- Endocrinology
- Medical Devices
- Diabetes Management
Background:
- Continuous glucose monitoring (CGM) is increasingly adopted in hospital settings.
- The effectiveness of CGM for adults with diabetic ketoacidosis (DKA) remains unestablished.
Purpose of the Study:
- To evaluate the efficacy of real-time CGM in assessing glycemic control in adults with DKA.
- To compare CGM performance against capillary point-of-care (POC) and basic metabolic panel (BMP) glucose measurements.
Main Methods:
- A single-center pilot study involving 52 adult patients with DKA (type 1 and type 2 diabetes).
- Comparison of real-time CGM (Dexcom G6) with POC and BMP glucose values during intravenous insulin therapy and post-DKA resolution.
- Analysis included Mean Absolute Relative Difference (MARD), median Absolute Relative Difference (ARD), and Diabetes Technology Society (DTS) Error Grid analysis.
Main Results:
- CGM demonstrated a Mean Absolute Relative Difference (MARD) of 17.4% compared to POC testing during IV insulin treatment.
- Diabetes Technology Society (DTS) Error Grid analysis showed 100% of CGM values in zones A+B during IV insulin treatment.
- CGM performance remained reliable post-DKA resolution, with MARD values comparable to POC and BMP measurements.
Conclusions:
- Real-time CGM is a reliable tool for monitoring glucose control in hospitalized adults with DKA.
- CGM can be effectively utilized during acute insulin treatment and after DKA resolution.
- Further multicenter randomized trials are warranted to confirm the benefits of CGM in hyperglycemic crises management.
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