Use of continuous glucose monitor in critically ill COVID-19 patients requiring insulin infusion: an observational study
Open accessAbstract
Context: The coronavirus disease 2019 (COVID-19) pandemic has created a need for remote blood glucose (BG) monitoring in the intensive care unit (ICU). Objective: To evaluate feasibility and patient safety of a hybrid monitoring strategy of point-of-care (POC) BG plus continuous glucose monitor (CGM) in the ICU. Design: Retrospective analysis. Setting: ICU of an academic medical center. Patients: Patients with COVID-19 on IV insulin. Intervention: After meeting initial validation criteria, CGM was used for IV insulin titration and POC BG was performed every 6 hours or as needed. Main Outcome Measures: Outcomes included frequency of POC BG, workflow, safety, and accuracy measures. Results: The study included 19 patients, 18 with CGM data, mean age 58 years, 89% on mechanical ventilation, 37% on vasopressors, and 42% on dialysis. The median time to CGM validation was 137 minutes (interquartile range [IQR] 114-206). During IV insulin, the median number of POC values was 7 (IQR 6-16) on day 1, and declined slightly thereafter (71% reduction compared with standard of 24/day). The median number of CGM values used nonadjunctively to titrate IV insulin was 11.5 (IQR 0, 15) on day 1 and increased thereafter. Time in range 70 to 180 mg/dL was 64 ± 23% on day 1 and 72 ± 16% on days 2 through 7, whereas time <70 mg/dL was 1.5 ± 4.1% on day 1 and <1% on days 2 through 7. Conclusions: This study provides data to support that CGM using a hybrid protocol is feasible, accurate, safe, and has potential to reduce nursing and staff workload.
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Hospital CGM was successfully used in conjunction with periodic POC monitoring in hybrid protocols used for intravenous insulin titrations, decreasing the burden of hourly POC testing.
“However, hospital CGM was successfully used in conjunction with periodic POC monitoring in hybrid protocols used for intravenous insulin titrations, decreasing the burden of hourly POC testing (54)(55)(56).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [54]
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Self-citation
- Authors
- Faulds, E. R., Boutsicaris, A., Sumner, L., Jones, L., McNett, M., Smetana, K. S., May, C. C., Buschur, E., Exline, M. C., Ringel, M. D., & Dungan, K.
- Affiliations
- The Ohio State University Wexner Medical Center (US)
- The Ohio State University (US)
- Implementation/Translation Science Core, Helene Fuld Health Trust National Institute for EBP, Columbus, OH, USA
- Corresponding author
- Faulds, Eileen R
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2021-06-08
- Volume
- 106
- Issue
- 10
- Pages
- e4007-e4016
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W3167297042
- Cited by
- 71
- References
- 37
- Citations by year
- 2026: 4 · 2025: 17 · 2024: 14 · 2023: 16 · 2022: 19 · 2021: 1
- FWCI
- 9.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ohio State University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- continuous glucose monitoring, COVID-19 pandemic, critically ill patients, intensive care unit, insulin infusion, insulin dose adjustment, time in range, hypoglycemia, nursing workload, remote glucose monitoring
- MeSH terms
- Glycemic Control, COVID-19, SARS-CoV-2, Adult, Aged, Blood Glucose, Diabetes Mellitus, Female, Humans, Infusions, Intravenous, Insulin, Intensive Care Units, Male, Middle Aged, Retrospective Studies, Blood Glucose Self-Monitoring, Comorbidity, Critical Illness, Treatment Outcome, Point-of-Care Systems, Diabetes Complications
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