Continuous Glucose Monitoring for Adult ICU Patients: A Meta-Analysis on Its Clinical Effectiveness

Area of Science:

• Critical Care Medicine
• Endocrinology
• Medical Technology

Background:

• Critically ill patients exhibit disrupted glucose metabolism, impacting clinical outcomes.
• Effective blood glucose management is vital for patient recovery in intensive care units (ICUs).
• The efficacy of continuous glucose monitoring (CGM) in adult ICUs remains debated.

Purpose of the Study:

• To systematically evaluate the impact of CGM versus conventional intermittent monitoring on glycemic control in adult ICU patients.
• To assess the effects of CGM on hypoglycemia, blood glucose levels, and mortality.

Main Methods:

• A systematic literature search was conducted across seven electronic databases.
• Included were 22 randomized controlled trials (RCTs) involving 1,396 adult ICU patients.
• A meta-analysis was performed to pool the data from eligible RCTs.

Main Results:

• CGM significantly reduced hypoglycemic events (RR = 0.41) and average blood glucose levels (MD = -0.34 mmol/L).
• CGM prolonged time in glycemic target range (MD = 10.12%) and decreased daily insulin use (MD = -22.17 U/day).
• CGM was associated with a significant reduction in total mortality (RR = 0.47).

Conclusions:

• CGM integration into routine ICU glycemic control is recommended, especially for patients with high glycemic variability or hypoglycemia risk.
• CGM offers a superior approach to managing blood glucose in critically ill adult patients.
• The findings support the use of CGM for improved outcomes in the ICU setting.