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Continuous Glucose Monitoring for Hyperglycemia in Critically Ill Patients: A Randomized Controlled Trial
Andrew J Franck1, Andrew L Hendrickson1, Evan D Telford1
1North Florida/South Georgia Veterans Health System, Gainesville, FL.
Chest
|February 16, 2025
Summary
Continuous glucose monitors (CGMs) did not significantly improve glycemic control in critically ill patients compared to standard monitoring. Routine use of CGMs in the ICU is not supported by this study.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Medical Devices
Background:
- Continuous glucose monitoring (CGM) offers potential benefits for hyperglycemia management in critically ill patients.
- Limited evidence currently supports the routine use of CGMs in the Intensive Care Unit (ICU).
Purpose of the Study:
- To evaluate if continuous glucose monitors (CGMs) improve time within the target glucose range in critically ill patients with hyperglycemia compared to standard care.
Main Methods:
- An investigator-initiated, single-center, randomized controlled trial.
- Adult ICU patients with hyperglycemia or diabetes were randomized to CGM or standard glucose monitoring.
- The primary outcome was the percentage of time within the normoglycemic range (70-180 mg/dL).
Main Results:
- Eighty-five participants were randomized (43 to CGM, 42 to standard care).
- No statistically significant difference was found in time within the target glucose range between the CGM group (60.5%) and the standard care group (61.4%).
- Secondary outcomes, except for patient satisfaction, also showed no significant differences.
Conclusions:
- Continuous glucose monitoring (CGM) does not demonstrate superiority over standard care for routine glucose monitoring in the ICU.
- Current evidence does not support the routine implementation of CGMs for critically ill patients based on this trial.
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