Related Experiment Video
Updated: May 12, 2025
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Accuracy of Factory-Calibrated Continuous Glucose Monitors in Critically Ill Patients Receiving Intravenous Insulin:
Gautam Ramesh1, Emily Kobayashi2, Navyaa Sharma3
1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Background:
Continuous glucose monitors (CGMs) are increasingly being used to guide glucose management in the hospital. However, uncertainty regarding their accuracy in this setting remains.
Methods:
We conducted a nonrandomized, open-label, clinically blinded prospective trial of the Dexcom G6 Pro (G6P) and FreeStyle Libre Pro (FLP) in the inpatient setting among critically ill hospitalized patients (n = 40) requiring continuous intravenous insulin infusion. In parallel with CGM data, reference serum (Lab) glucose and point-of-care (POC) glucose values were obtained. On completion of the study, CGM and reference values were analyzed to assess CGM accuracy.
Results:
A total of 1015 matched G6P-Lab pairs had a mean absolute relative difference (MARD) of 22.7%, 2369 G6P-POC pairs had an MARD of 22.9%, 1006 matched FLP-Lab pairs had an MARD of 25.2%, and 2353 FLP-POC pairs had an MARD of 27.0%. Both CGM systems demonstrated considerable inter-patient variability in sensor accuracy and tended to underestimate glucose in comparison with the reference values. Rarely were low reference values overestimated by either sensor.
Conclusions:
Factory-calibrated continuous glucose monitors may require accuracy validation and per-patient calibration for inpatient use in critically ill patients.
