Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center.
Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center.
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DOI：
10.1016/j.eprac.2022.12.012
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发表时间：
2023-03
影响因子：
4.2
通讯作者：
Chindris, Ana-Maria
中科院分区：
文献类型：
--
作者：
Dumitrascu, Adrian G.;Perry, Michelle F.;Boone, Rebecca J.;Guzman, Maria P.;Chirila, Razvan M.;McNally, Allyson W.;Colibaseanu, Dorin T.;Meek, Shon E.;Ball, Colleen T.;White, Launia J.;Chindris, Ana-Maria
因COVID-19和高血糖症住院的患者需要频繁进行血糖监测，通常使用血糖仪进行。动态血糖监测仪（CGMs）在门诊环境中很常见，但尚未批准用于医院。我们在20名因COVID-19和高血糖症住院的成人患者中评估了CGM的准确性、胰岛素给药的安全性和CGM的临床可靠性。研究患者配备了远程监测的CGM。根据血糖仪读数评价CGM值。如有必要，进行CGM传感器校准。CGM值用于胰岛素给药，无需血糖仪确认。使用812对血糖仪-CGM值计算血糖仪的CGM准确度，表示为平均绝对相对差（MARD）。总MARD为10.4%。对于在范围内的时间以及1级和2级高血糖，MARD分别为11.4%、9.4%和9.1%，医疗楼层和重症监护室之间的差异很小。MARD与平均动脉血压水平、血氧饱和度、每日血红蛋白水平和肾小球滤过率无相关性。CGM临床可靠性高，99.7%的CGM值落在Clarke误差网格的“安全”区域内。CGM放置后，血糖仪测量频率从每天5次降至3次，然后降至2次，减少了护士在病房的出现并限制了病毒暴露。通过每日两次按需校准，住院患者使用CGM进行胰岛素给药是安全的，降低了血糖仪手指针刺的频率。对于血糖水平>70 mg/dL，CGMs显示出足够的准确性，没有生命值和实验室值的干扰。
Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia. Study patients were fitted with a remotely monitored CGM. CGM values were evaluated against glucometer readings. The CGM sensor calibration was performed if necessary. CGM values were used to dose insulin, without glucometer confirmation. CGM accuracy against glucometer, expressed as mean absolute relative difference (MARD), was calculated using 812 paired glucometer-CGM values. The aggregate MARD was 10.4%. For time in range and grades 1 and 2 hyperglycemia, MARD was 11.4%, 9.4%, and 9.1%, respectively, with a small variation between medical floors and intensive care units. There was no MARD correlation with mean arterial blood pressure levels, oxygen saturation, daily hemoglobin levels, and glomerular filtration rates. CGM clinical reliability was high, with 99.7% of the CGM values falling within the “safe” zones of Clarke error grid. After CGM placement, the frequency of glucometer measurements decreased from 5 to 3 and then 2 per day, reducing nurse presence in patient rooms and limiting viral exposure. With twice daily, on-demand calibration, the inpatient CGM use was safe for insulin dosing, decreasing the frequency of glucometer fingersticks. For glucose levels >70 mg/dL, CGMs showed adequate accuracy, without interference from vital and laboratory values.
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影响因子：
5
作者：
Sadhu, Archana R.;Serrano, Ivan Alexander;Patham, Bhargavi
通讯作者：
Patham, Bhargavi
影响因子：
5
作者：
Bode, Bruce;Garrett, Valerie;Klonoff, David C.
通讯作者：
Klonoff, David C.
影响因子：
16.2
作者：
CLARKE, WL;COX, D;POHL, SL
通讯作者：
POHL, SL
影响因子：
3.9
作者：
Kapoor R;Timsina LR;Gupta N;Kaur H;Vidger AJ;Pollander AM;Jacobi J;Khare S;Rahman O
通讯作者：
Rahman O
DOI：
10.1016/j.eprac.2021.01.011
发表时间：
2021-04
期刊：
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
影响因子：
--
作者：
Faulds ER;Jones L;McNett M;Smetana KS;May CC;Sumner L;Buschur E;Exline M;Ringel MD;Dungan K
通讯作者：
Dungan K