TY - JOUR
T1 - Accuracy of subcutaneous continuous glucose monitoring in critically ill adults
T2 - improved sensor performance with enhanced calibrations
AU - Leelarathna, Lalantha
AU - English, Shane W
AU - Thabit, Hood
AU - Caldwell, Karen
AU - Allen, Janet M
AU - Kumareswaran, Kavita
AU - Wilinska, Malgorzata E
AU - Nodale, Marianna
AU - Haidar, Ahmad
AU - Evans, Mark L
AU - Burnstein, Rowan
AU - Hovorka, Roman
PY - 2014/2
Y1 - 2014/2
N2 - OBJECTIVE: Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration.SUBJECTS AND METHODS: In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m(2); mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6-19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1-6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer.RESULTS: In total, 1,060 CGM-ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122-213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%).CONCLUSIONS: Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non-critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements.
AB - OBJECTIVE: Accurate real-time continuous glucose measurements may improve glucose control in the critical care unit. We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration.SUBJECTS AND METHODS: In a randomized trial, paired CGM and reference glucose (hourly arterial blood glucose [ABG]) were collected over a 48-h period from 24 adults with critical illness (mean±SD age, 60±14 years; mean±SD body mass index, 29.6±9.3 kg/m(2); mean±SD Acute Physiology and Chronic Health Evaluation score, 12±4 [range, 6-19]) and hyperglycemia. In 12 subjects, the CGM device was calibrated at variable intervals of 1-6 h using ABG. In the other 12 subjects, the sensor was calibrated according to the manufacturer's instructions (1, 2, 10, and 24 h) using arterial blood and the built-in point-of-care glucometer.RESULTS: In total, 1,060 CGM-ABG pairs were analyzed over the glucose range from 4.3 to 18.8 mmol/L. Using enhanced calibration median (interquartile range) every 169 (122-213) min, the absolute relative deviation was lower (7.0% [3.5, 13.0] vs. 12.8% [6.3, 21.8], P<0.001), and the percentage of points in the Clarke error grid Zone A was higher (87.8% vs. 70.2%).CONCLUSIONS: Accuracy of the Navigator CGM device during critical illness was comparable to that observed in non-critical care settings. Further significant improvements in accuracy may be obtained by frequent calibrations with ABG measurements.
KW - Biosensing Techniques
KW - Blood Glucose/analysis
KW - Calibration
KW - Critical Illness/therapy
KW - Female
KW - Glycated Hemoglobin A/analysis
KW - Humans
KW - Hyperglycemia/metabolism
KW - Intensive Care Units
KW - Male
KW - Monitoring, Physiologic/methods
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Reproducibility of Results
U2 - 10.1089/dia.2013.0221
DO - 10.1089/dia.2013.0221
M3 - Article
C2 - 24180327
SN - 1520-9156
VL - 16
SP - 97
EP - 101
JO - Diabetes technology & therapeutics
JF - Diabetes technology & therapeutics
IS - 2
ER -
