Remote Continuous Glucose Monitoring With a Computerized Insulin Infusion Protocol for Critically Ill Patients in a COVID-19 Medical ICU : Proof of Concept

© 2021 by the American Diabetes Association..

OBJECTIVE: The use of remote real-time continuous glucose monitoring (CGM) in the hospital has rapidly emerged to preserve personal protective equipment and reduce potential exposures during coronavirus disease 2019 (COVID-19).

RESEARCH DESIGN AND METHODS: We linked a hybrid CGM and point-of-care (POC) glucose testing protocol to a computerized decision support system for continuous insulin infusion and integrated a validation system for sensor glucose values into the electronic health record. We report our proof-of-concept experience in a COVID-19 intensive care unit.

RESULTS: All nine patients required mechanical ventilation and corticosteroids. During the protocol, 75.7% of sensor values were within 20% of the reference POC glucose with an associated average reduction in POC of 63%. Mean time in range (70-180 mg/dL) was 71.4 ± 13.9%. Sensor accuracy was impacted by mechanical interferences in four patients.

CONCLUSIONS: A hybrid protocol integrating real-time CGM and POC is helpful for managing critically ill patients with COVID-19 requiring insulin infusion.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Diabetes care - Vol. 44, No. 4 (2021), p. 1055-1058

Language:

English

Contributors:

Davis, Georgia M
Faulds, Eileen
Walker, Tara
Vigliotti, Debbie
Rabinovich, Marina
Hester, Joi
Peng, Limin
McLean, Barbara
Hannon, Patricia
Poindexter, Norma
Saunders, Petrena
Perez-Guzman, Citlalli
Tekwani, Seema S
Martin, Greg S
Umpierrez, Guillermo
Agarwal, Shivani
Dungan, Kathleen
Pasquel, Francisco J

Links:

Volltext

Keywords:

*COVID-19
*Diabetes Complications
*Insulin Infusion Systems
*Remote Sensing Technology
Aged
Aged, 80 and over
Algorithms
Blood Glucose
Blood Glucose Self-Monitoring
Clinical Trial
Critical Illness
Equipment and Supplies
Female
Humans
Insulin
Intensive Care Units
Journal Article
Male
Middle Aged
Point-of-Care Systems
Proof of Concept Study
Research Support, N.I.H., Extramural
SARS-CoV-2

Notes:

Date Completed 01.04.2021

Date Revised 14.04.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.2337/dc20-2085

PMID:

33563655

PPN (Catalogue-ID):

NLM322288908