Continuous Glucose Monitoring Shows Benefit in Critically Ill

Real-time CGM not found to improve glycemic control, but reduces severe hypoglycemic events
By Eric Metcalf
HealthDay Reporter

TUESDAY, March 23 (HealthDay News) -- Real-time continuous glucose monitoring (CGM) in critically ill patients reduces severe hypoglycemic events, but doesn't lead to better glycemic control compared to intensive insulin therapy based on an algorithm, according to research published in the March issue of Diabetes Care.

Ulrike Holzinger, M.D., of the Medical University of Vienna in Austria, and colleagues analyzed data from 124 patients in an intensive care unit who were using mechanical ventilation. Patients were randomized to receive real-time CGM or selective glucose measurement according to an algorithm for 72 hours. Rates of insulin infusion were guided by the same algorithm in both groups.

The researchers found that the CGM and control groups spent a similar percentage of time at a glucose level below 110 mg/dL (59 versus 55 percent). Mean glucose levels were also similar (106 and 111 mg/dL, respectively). However, the rate of severe hypoglycemia was lower in the CGM group (1.6 versus 11.5 percent). CGM was associated with a 9.9 percent lower absolute risk of severe hypoglycemia.

"The results of our study indicate that real-time CGM increases the safety of tight glycemic control in critically ill patients by significantly reducing severe hypoglycemic events. However, real-time CGM could not improve glucose control defined as percentage of time at <110 mg/dL," the authors conclude.

Medtronic Austria donated equipment for the study.

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