Related Experiment Video

Updated: Sep 14, 2025

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

19.0K

Continuous Glucose Monitors Have Acceptable Accuracy but High Discordance at High and Low Glucose Concentrations in

Isaiah K Mensah1, Vahid Azimi1, Christopher W Farnsworth1

  • 1Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, MO, United States.

Clinical Chemistry
|July 25, 2025
PubMed

Insights

Continuous glucose monitors (CGMs) show acceptable accuracy in hospitalized children but have high discordance with point-of-care tests. Confirmatory testing is needed for critical glucose levels.

Area of Science:

  • Pediatric Endocrinology
  • Medical Device Technology
  • Clinical Diagnostics

Background:

  • Continuous glucose monitors (CGMs) are vital for diabetes management in outpatient settings.
  • Limited data exists on CGM performance in hospitalized pediatric populations, particularly at critical glucose thresholds.

Purpose of the Study:

  • To evaluate the accuracy and performance of CGMs in hospitalized pediatric patients.
  • To assess CGM concordance with laboratory and point-of-care glucose measurements.
  • To determine the clinical utility of CGMs at high and low glucose levels.

Main Methods:

  • Retrospective analysis of 72 hospitalized pediatric patients with dysglycemia using CGMs.
  • Comparison of paired CGM, laboratory (Lab), and point-of-care (POC) glucose results.
  • Assessment of Mean Absolute Relative Difference (MARD) and Parkes error zones.
  • Evaluation of CGM concordance with POC results at hypoglycemic (<70 mg/dL) and hyperglycemic (>180 mg/dL) ranges.

Main Results:

  • A total of 2228 paired results yielded a MARD of 14.8%, with 99.2% within acceptable Parkes error zones (A and B).
  • MARD was 20.2% for hypoglycemia and 13.6% for hyperglycemia.
  • CGM and POC concordance showed a Cohen kappa of 0.66; however, CGM results at critical levels were confirmed by POC only 80.2% (hypoglycemia) and 16.5% (hyperglycemia) of the time.

Conclusions:

  • CGM accuracy is clinically acceptable in hospitalized pediatric patients.
  • Significant discordance exists between CGM and POC glucose measurements, especially at critical values.
  • Clinical guidelines should emphasize confirmatory testing for critical glucose readings obtained via CGM in hospitalized children.
Abstract

More Related Videos

Simple Continuous Glucose Monitoring in Freely Moving Mice03:25

Simple Continuous Glucose Monitoring in Freely Moving Mice

Published on: February 24, 2023

6.0K
Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique07:35

Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique

Published on: January 26, 2024

1.6K

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
338
Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
929
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
694