Continuous glucose monitoring in the operating room and cardiac intensive care unit
Open accessAbstract
Rapid implementation of remote continuous glucose monitoring (CGM) is occurring across hospitals during the coronavirus disease 2019 (COVID-19) pandemic. Despite limited experience, the U.S. Food and Drug Administration is not objecting to the inpatient use of CGM to limit the exposure of health care workers to severe acute respiratory syndrome coronavirus 2 and to reduce the waste of personal protective equipment (1). Recent efforts in non–intensive care unit (ICU) patients suggest that CGM devices are accurate in the inpatient setting and can help monitor patients remotely (2,3). In addition, two recent small trials enrolling non-ICU patients confirm the feasibility of using remote real-time CGM in the hospital (4,5). The accuracy of sensors, however, may be affected during various conditions that have not been well studied (i.e., MRI, surgery, shock requiring vasopressor therapy, hypoxia) (1). To mitigate potential CGM inaccuracy, a hybrid approach using real-time CGM with periodic point-of-care (POC) validation has been suggested (1). We report here on the likely loss of sensor signal during cardiac surgery and potential loss of accuracy in the operating room (OR). We also report on the accuracy of sensors that recovered immediately after surgery during critical illness. We evaluated the performance of sensors in adults without diabetes undergoing scheduled or urgent coronary artery bypass surgery (CABG). We excluded …
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In hospitalized patients monitored with capillary glucose before meals and at bedtime, about 45% experience asymptomatic hypoglycemia.
“Prospective observational studies, using the current standard of care of checking capillary glucose before meals and at bedtime, have shown that about 45% of persons experience asymptomatic hypoglycemia events.1387,1388”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1387]
The paper’s main text reports sensor accuracy in 15 adults undergoing coronary artery bypass surgery, not the frequency of asymptomatic hypoglycemia in hospitalized patients. Searches for “45% asymptomatic hypoglycemia before meals and at bedtime” and “asymptomatic hypoglycemia capillary glucose monitoring hospitalized patients” found no passage addressing that estimate or monitoring schedule. No page numbers are available in our copy. (LLM, conf=0.76)
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Self-citationContinuous Glucose Monitoring Use in Special Situations
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- Authors
- Perez-Guzman, M. C., Duggan, E., Gibanica, S., Cardona, S., Corujo-Rodriguez, A., Faloye, A., Halkos, M., Umpierrez, G. E., Peng, L., Davis, G. M., & Pasquel, F. J.
- Affiliations
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Emory University (US)
- Corresponding author
- Pasquel, Francisco J.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-01-21
- Volume
- 44
- Issue
- 3
- Pages
- e50-e52
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC7896262
- OpenAlex
- W3122413971
- Cited by
- 90
- References
- 5
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 24 · 2023: 15 · 2022: 14 · 2021: 6
- FWCI
- 11.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of General Medical Sciences (1K23DK122199-01A1)
- 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 › Surgery › Healthcare Technology and Patient Monitoring
- Keywords
- continuous glucose monitoring, sensor accuracy, operating room, cardiac surgery, coronary artery bypass grafting, cardiac intensive care unit, critical illness, remote glucose monitoring, COVID-19 pandemic, healthcare worker exposure, personal protective equipment
- MeSH terms
- Blood Glucose, Critical Care, Humans, Intensive Care Units, Monitoring, Physiologic, Operating Rooms, Blood Glucose Self-Monitoring
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