Pre- and Postoperative Accuracy and Safety of a Real-Time Continuous Glucose Monitoring System in Cardiac Surgical Patients: A Randomized Pilot Study

Logtenberg, S. J. J.; Kleefstra, Nanne; Snellen, Ferdinand T.; Groenier, Klaas H.; Slingerland, R. J.; Nierich, Arno P.; Bilo, Henk J. G.

doi:10.1089/dia.2008.0028

Cited by 48 publications

(44 citation statements)

References 22 publications

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“…Several studies have reported on the accuracy of CGM in critically ill patients. [39][40][41] Most of these studies included a small number of patients and limited their analysis to retrospective comparisons of a reference pointof-care value with CGM data. 38 The use of CGM may have an advantage over bedside point-of-care testing in that it has the potential to reduce the possibility of unknown hypoglycemic events that may occur between point-of-care measurements; however, some studies have raised concern on the accuracy of CGM at low BG levels and limited correlation between CGM and both capillary and arterial samples when the BG is less than 81 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

Floyd

Prakash

Hall

et al. 2012

J Diabetes Sci Technol

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

Floyd

Prakash

Hall

et al. 2012

J Diabetes Sci Technol

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“…1,2 Several clinical studies have indicated that utilization of CGM data, both retrospectively and in real time, can help adjust insulin therapies, prevent (or minimize the occurrence of) extreme glycemic excursions, 3,4 reduce glycated hemoglobin values, 5,6,7 and achieve a tight glycemic control in both intensive care 8,9 and surgical units. 10 Despite these clear advantages, utilization of CGM techniques is still limited in the current clinical practice, mainly because of concerns about their accuracy, reliability, robustness, and patient tolerability. As a direct consequence, tremendous research efforts from both the scientific community and medical diagnostics companies have been devoted to the development of accurate, reliable, minimally invasive, and automated CGM systems (CGMSs).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Clinical Accuracy of GlucoMen®Day: A Novel Microdialysis-Based Continuous Glucose Monitor

Valgimigli

Lucarelli

Scuffi

et al. 2010

J Diabetes Sci Technol

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Background: The objective of this work was to determine the clinical accuracy of GlucoMen®Day, a new microdialysis-based continuous glucose monitoring system (CGMS) from A. Menarini Diagnostics (Florence, Italy). Accuracy evaluation was performed using continuous glucose-error grid analysis (CG-EGA), as recommended by the Performance Metrics for Continuous Interstitial Glucose Monitoring; Approved Guideline (POCT05-A). Methods: Two independent clinical trials were carried out on patients with types 1 and 2 diabetes mellitus, the glycemic levels of whom were monitored in an in-home setting for 100-hour periods. A new multiparametric algorithm was developed and used to compensate in real-time the GlucoMen®Day signal. The time lag between continuous glucose monitoring (CGM) and reference data was first estimated using the Poincaré plot method. The entire set of CGM/reference data pairs was then evaluated following the CG-EGA criteria, which allowed an estimation of the combined point and rate accuracy stratified by glycemic ranges. Results: With an estimated time lag of 11 minutes, the linear regression analysis of the CGM/reference glucose values yielded r = 0.92. The mean absolute error (MAE) was 11.4 mg/dl. The calculated mean absolute rate deviation (MARD) was 0.63 mg/dl/min. The data points falling within the A+B zones of CG-EGA were 100% in hypoglycemia, 95.7% in euglycemia, and 95.2% in hyperglycemia. Conclusions: The GlucoMen®Day system provided reliable, real-time measurement of subcutaneous glucose levels in patients with diabetes for up to 100 hours. The device showed the ability to follow rapid glycemic excursions and detect severe hypoglycemic events accurately. Its accuracy parameters fitted the criteria of the state-of-the-art consensus guideline for CGMS, with highly consistent results from two independent studies.

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“…BMI, body mass index; EF, ejection fraction; WBC, white blood cell; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol Data are reported as the mean ± SD or n (%). BMI, body mass index; EF, ejection fraction; WBC, white blood cell; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol other studies argued that CGMS glucose values are not sufficiently accurate and reliable to be used for therapeutic decisions [30][31][32]. Currently, clinical experience with CGMS in CCUs is limited, particularly for STEMI patients undergoing p-PCI.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and safety of continuous glucose monitoring systems in acute myocardial infarction subjects undergoing primary percutaneous coronary interventions

Zhang¹,

Ling²,

Cao³

et al. 2015

CIM

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Feasibility and safety of continuous glucose monitoring systems in acute myocardial infarction subjects undergoing primary percutaneous coronary interventions AbstractPurpose: The purpose of this study was to evaluate the feasibility and safety of continuous glucose monitoring systems (CGMS) in ST segment elevation myocardial infarction (S-TEMI) patients undergoing primary percutaneous coronary interventions (p-PCI) in coronary care units (CCU).Methods: CGMS was performed for 3 days during CCU hospitalization for each of the subjects. The correlation between glucose values, recorded with CGMS, and finger-stick capillary glucose values was examined. The parameters and safety of CGMS were also investigated.Results: Data from 219 subjects were included in the statistical analysis. Correlation analysis showed a strong positive correlation between interstitial glucose values recorded by CGMS and the corresponding capillary glucose values (P<0.001). The daytime mean blood glucose MBG), the nighttime MBG and PT7.8 were the highest in the first day of CGMS compared with the second and third day. Furthermore, there were no indications of major hemorrhage or hematoma at the site of sensor insertion. Any adverse events were mild.Conclusions: CGMS glucose values are relatively accurate and reliable. CGMS were safe and can be used as a tool to detect trends in glucose levels and to predict upcoming glucose excursions in STEMI patients undergoing p-PCI. It is commonly accepted that continuous glucose monitoring systems (CGMS) can provide detailed and accurate glucose information. Relaying this detailed glucose information to patients has been shown to have a positive influence on glycemic control, including reductions in glucose variability, time spent in nocturnal hypoglycemia, time spent in hyperglycemia and levels of glycosylated hemoglobin [1][2][3][4]. Hyperglycemia commonly occurs during acute myocardial infarction (AMI), and in-hospital hyperglycemia is a strong predictor of mortality in AMI patients both with and without a history of diabetes mellitus [5][6]. The adverse outcomes associated with in-hospital hyperglycemia have prompted professional societies to recommend glucose control in AMI patients [5][6][7]; however, implementation of glucose control has been hindered by fear of hypoglycemia, as low glucose levels have been associated with adverse outcomes in AMI patients [8][9]. Patients with STsegment elevation myocardial infarction (STEMI) who are undergoing primary percutaneous coronary interventions (p-PCI) should receive aggressive management and treatment in coronary care units (CCU). As glucose management is a significant component of CCU activity, CGMS are particularly attractive for managing blood glucose (BG) because of their potential to detect hypo-and hyperglycemia as they occur. Many studies have concluded that CGMS face challenges in terms of sensitivity, stability, calibration and the physiological delay between BG and interstitial glucose (IG) concentration [10][11][12]. Moreover, CGMS are more e...

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Pre- and Postoperative Accuracy and Safety of a Real-Time Continuous Glucose Monitoring System in Cardiac Surgical Patients: A Randomized Pilot Study

Abstract: Although the RT-CGMS is safe and accurate according to accepted standards, there are still small aberrations, which in our opinion preclude unlimited use in its present form in a clinical setting. The effect of the alarm function at different glucose levels remains to be investigated.

Cited by 48 publications

References 22 publications

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

Evaluating the Clinical Accuracy of GlucoMen®Day: A Novel Microdialysis-Based Continuous Glucose Monitor

Feasibility and safety of continuous glucose monitoring systems in acute myocardial infarction subjects undergoing primary percutaneous coronary interventions

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