Continuous Glucose Monitoring Measures Can Be Used for Glycemic Control in the ICU: An In-Silico Study

Journal of Diabetes Science and Technology
Tony ZhouJ Geoffrey Chase

Abstract

Continuous glucose monitoring (CGM) technology has become more prevalent in the intensive care unit (ICU), offering potential benefits of increased safety and reduced workload in glycemic control (GC). The drift and higher point accuracy errors of CGM devices over traditional intermittent blood glucose (BG) measures have so far limited their application in the ICU. This study delineates the trade-offs of performance, safety and workload that CGM sensors provide in GC protocols. Clinical data from 236 patients were used for clinically validated virtual trials. A CGM-enabled version of the STAR GC protocol was used to evaluate the use of guard rails and rolling windows. Safety was assessed through percentage of patients who had a severe hypoglycemic episode (BG < 40 mg/dl) as well as percentage of resampled BG < 72 mg/dl. Performance was assessed as percentage of resampled measurements in the 80-126 mg/dl and the 80-144 mg/dl target bands. Workload was measured by number of manual BG measures per day. CGM-enabled versions of STAR decreased the number of required blood draws by up to 74%, while maintaining performance (76.6% BG measurements in the 80-126 mg/dl range vs 62.8% clinically, 87.9% in the 80-144 mg/dl range vs 83.7% cli...Continue Reading

References

Feb 24, 2001·Critical Care Clinics·K C McCowenB R Bistrian
Jul 27, 2001·Diabetes Technology & Therapeutics·T M GrossJ J Mastrototaro
Jul 27, 2001·Diabetes Technology & Therapeutics·M V Pishko
Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Jan 22, 2002·Best Practice & Research. Clinical Endocrinology & Metabolism·B A Mizock
Mar 13, 2002·The Journal of Clinical Endocrinology and Metabolism·Guillermo E UmpierrezAbbas E Kitabchi
Oct 16, 2003·JAMA : the Journal of the American Medical Association·Simon J FinneyTimothy W Evans
May 19, 2004·Intensive Care Medicine·Christian ChristiansenElse Tønnesen
Jun 17, 2004·Diabetes Technology & Therapeutics·Philip A GoldbergSilvio E Inzucchi
Feb 22, 2005·Computer Methods and Programs in Biomedicine·Christopher E HannGeoffrey M Shaw
Sep 27, 2005·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Pascale Carayon, Ayşe P Gürses
May 2, 2006·Computer Methods and Programs in Biomedicine·J Geoffrey ChaseGeoffrey M Shaw
Aug 15, 2006·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Anthony P Furnary, YingXing Wu
Oct 20, 2007·Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society·Matthew Kuure-KinseyB Wayne Bequette
Nov 6, 2007·Current Drug Delivery·J Geoffrey ChaseChristopher E Hann
Jan 11, 2008·The New England Journal of Medicine·Frank M BrunkhorstUNKNOWN German Competence Network Sepsis (SepNet)
Mar 15, 2008·Diabetes Care·Boris KovatchevWilliam Clarke
Apr 17, 2008·Critical Care : the Official Journal of the Critical Care Forum·J Geoffrey ChaseChristopher Hann
Jul 22, 2008·Physiological Measurement·Roman HovorkaMalgorzata E Wilinska
Aug 30, 2008·JAMA : the Journal of the American Medical Association·Renda Soylemez WienerRobin J Larson
Mar 26, 2009·The New England Journal of Medicine·Simon FinferJuan J Ronco
May 16, 2009·Journal of Diabetes Science and Technology·Boris P KovatchevClaudio Cobelli
May 26, 2009·Lancet·Kathleen M DunganJean-Charles Preiser
Jun 19, 2009·Critical Care : the Official Journal of the Critical Care Forum·Sean M BagshawUNKNOWN ANZICS CORE Management Committee
Sep 15, 2009·Journal of Diabetes Science and Technology·Marc Breton, Boris Kovatchev
Jul 1, 2007·Journal of Diabetes Science and Technology·Jaques ReifmanW Kenneth Ward
May 1, 2008·Journal of Diabetes Science and Technology·J Geoffrey ChaseGeoffrey M Shaw
Feb 20, 2010·Journal of Diabetes Science and Technology·Christopher G PrettyMatthew Signal
Feb 20, 2010·Journal of Diabetes Science and Technology·D Barry KeenanJohn J Mastrototaro
Feb 24, 2010·Mayo Clinic Proceedings·Moritoki EgiMichael Bailey
Mar 24, 2010·Journal of Diabetes Science and Technology·Fatanah SuhaimiJ Geoffrey Chase
Apr 14, 2010·Critical Care Medicine·Jeroen HermanidesJ Hans DeVries
Jun 2, 2010·Journal of Diabetes Science and Technology·Matthew SignalGeoffrey M Shaw
Dec 16, 2010·Biomedical Engineering Online·J Geoffrey ChaseThomas Desaive
Feb 4, 2011·Computer Methods and Programs in Biomedicine·Jessica LinJ Geoffrey Chase
Feb 10, 2011·Journal of Diabetes Science and Technology·McGarraugh GeoffreyWeinstein Richard
Sep 21, 2011·Annals of Intensive Care·Alicia EvansJ Geoffrey Chase
Mar 10, 2012·Journal of Diabetes Science and Technology·Alicia EvansJ Geoffrey Chase

❮ Previous
Next ❯

Citations

Feb 18, 2020·Journal of Diabetes Science and Technology·Ralph ZieglerBernd Kulzer
Jan 15, 2019·Journal of Diabetes Science and Technology·Pedro D Salinas, Carlos E Mendez
Jul 2, 2020·Medical Devices : Evidence and Research·Athirah Abdul RazakJames Geoffrey Chase
May 1, 2020·Biomedical Engineering Online·Vincent UyttendaeleJ Geoffrey Chase
Jun 4, 2021·Journal of Diabetes Science and Technology·Anane YahiaBalazs Benyo

❮ Previous
Next ❯

Methods Mentioned

BETA
blood draws

Software Mentioned

STAR
GlySure

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.