Performance of a factory-calibrated, real-time continuous glucose monitoring system during elective abdominal surgery
Performance of a factory-calibrated, real-time continuous glucose monitoring system during elective abdominal surgery
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DOI：
10.1111/dom.14073
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发表时间：
2020-06-13
影响因子：
5.8
通讯作者：
Bally, Lia
中科院分区：
文献类型：
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作者：
Tripyla, Afroditi;Herzig, David;Bally, Lia
我们评估了工厂校准的第六代连续血糖监测（CGM）系统Dexcom G6 (R) （Dexcom Inc., San Diego, California）在选择性腹部手术中的性能。20名接受腹部手术的成人（预）糖尿病患者（术前2小时）；15名男性，年龄69 +/- 13岁，糖化血红蛋白53 +/- 14 mmol/mol)从手术前1周佩戴该传感器直至出院。从麻醉诱导至术后2小时，每20分钟使用Accu-Chek (R) Inform II测量仪（Roche Diabetes Care, Mannheim, Germany）测量参考毛细血管血糖值。在此期间，主要终点是传感器和参考方法之间的平均绝对相对差（ARD）。总共获得1207个CGM/参考对。在围手术期（523对），平均+/- SD和中位数（四分位间距[IQR]） ARD分别为12.7% +/- 8.7%和9.9(6.3;15.9)%，67.4%的传感器读数在国际标准化组织15197:2013的限制范围内。CGM高估了参考葡萄糖1.1 +/- 0.8 mmol/L（95%一致性限-0.5;2.7 mmol/L）。Clarke误差网格区A或B包含99.2%的配对（A: 78.8%; B: 20.4%）。围术期传感器可用性中位数（IQR）为98.6%(95.9;100.0)%。无临床显著不良事件发生。总之，Dexcom G6装置在择期腹部手术中表现出一致和可接受的准确性，为围手术期血糖管理开辟了新的途径。
We assessed the performance of the factory-calibrated, sixth-generation continuous glucose monitoring (CGM) system Dexcom G6 (R) (DexCom Inc., San Diego, California) during elective abdominal surgery. Twenty adults with (pre)diabetes undergoing abdominal surgery (>2 hours; 15 men, age 69 +/- 13 years, glycated haemoglobin 53 +/- 14 mmol/mol) wore the sensor from 1 week prior to surgery until hospital discharge. From induction of anaesthesia until 2 hours post-surgery, reference capillary glucose values were obtained every 20 minutes using the Accu-Chek (R) Inform II meter (Roche Diabetes Care, Mannheim, Germany). The primary endpoint was the mean absolute relative difference (ARD) between sensor and reference method during this period. In total, 1207 CGM/reference pairs were obtained. In the peri-operative period (523 pairs), mean +/- SD and median (interquartile range [IQR]) ARD were 12.7% +/- 8.7% and 9.9 (6.3;15.9)%, respectively, and 67.4% of sensor readings were within International Organization of Standardization 15197:2013 limits. CGM overestimated reference glucose by 1.1 +/- 0.8 mmol/L (95% limits of agreement -0.5;2.7 mmol/L). Clarke error grid zones A or B contained 99.2% of pairs (A: 78.8%; B: 20.4%). The median (IQR) peri-operative sensor availability was 98.6 (95.9;100.0)%. No clinically significant adverse events occurred. In conclusion, the Dexcom G6 device showed consistent and acceptable accuracy during elective abdominal surgery, opening new avenues for peri-operative glucose management.