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Accuracy and Reliability of Intermittent Scanning and Real-Time Continuous Glucose Monitoring Systems in Diabetes
Lukas van Baal1, Lutz Heinemann2, Johanna Reinold3
1Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Journal of Diabetes Science and Technology
|April 23, 2025
Summary
Continuous glucose monitoring (CGM) systems demonstrate high accuracy and reliability for inpatient diabetes care, even in emergencies. This study confirms their usability in hospital settings for better glucose management.
Area of Science:
- Endocrinology
- Medical Devices
- Clinical Informatics
Background:
- Hospitalized patients with diabetes present significant management challenges.
- Continuous glucose monitoring (CGM) offers superior glucose assessment compared to traditional capillary measurements.
- Limited data exist on CGM use in hospitalized patients, particularly during diabetes-related emergencies.
Purpose of the Study:
- To assess the real-world usability and accuracy of intermittent scanning and real-time CGM devices in patients admitted for diabetes emergencies.
- To provide data on CGM performance in an acute inpatient setting.
Main Methods:
- A single-center prospective study involving 151 patients admitted due to diabetes emergencies.
- Evaluation of CGM accuracy using Mean Absolute Relative Difference (MARD), Clark Error Grid (CEG), and Bland Altman analysis (BAA).
- Application of modified Food and Drug Administration (FDA) criteria for accuracy assessment.
Main Results:
- Analysis of 1,498 CGM/POC-glucose pairs showed a MARD of 10.8%, with improved accuracy in higher glucose ranges.
- CEG analysis indicated 99.1% of values in optimal/acceptable zones; BAA showed 96.0% within limits.
- Modified FDA criteria revealed 90.7% agreement within ±20 mg/dL or ±20%.
Conclusions:
- Continuous glucose monitoring (CGM) is a usable and accurate tool for inpatient diabetes management.
- The study demonstrates high reliability of CGM measurements in hospitalized patients experiencing diabetes emergencies.
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