Accuracy of Dexcom G6 continuous glucose monitoring in non-critically ill hospitalized patients with diabetes

Davis, Georgia M.; Spanakis, Elias K.; Migdal, Alexandra L.; Singh, Lakshmi G.; Albury, Bonnie; Urrutia, Maria Agustina; Zamudio-Coronado, K. Walkiria; Scott, William H.; Doerfler, Rebecca; Lizama, Sergio; Satyarengga, Medha; Munir, Kashif; Galindo, Rodolfo J.; Vellanki, Priyathama; Cardona, Saumeth; Pasquel, Francisco J.; Peng, Limin; Umpierrez, Guillermo E.

doi:10.2337/dc20-2856

Cited by 160Diabetes Management and ResearchHyperglycemia and glycemic control in critically ill and hospitalized patientsClinical Laboratory Practices and Quality Control

Accuracy of Dexcom G6 continuous glucose monitoring in non-critically ill hospitalized patients with diabetes

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Davis, Georgia M., Spanakis, Elias K., Migdal, Alexandra L., Singh, Lakshmi G., Albury, Bonnie, Urrutia, Maria Agustina, Zamudio-Coronado, K. Walkiria, Scott, William H. +10 more·2021·Diabetes Care

DOI 10.2337/dc20-2856PMC PMC8323182

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Abstract

OBJECTIVE: Advances in continuous glucose monitoring (CGM) have transformed ambulatory diabetes management. Until recently, inpatient use of CGM has remained investigational, with limited data on its accuracy in the hospital setting. RESEARCH DESIGN AND METHODS: To analyze the accuracy of Dexcom G6, we compared retrospective matched-pair CGM and capillary point-of-care (POC) glucose data from three inpatient CGM studies (two interventional and one observational) in general medicine and surgery patients with diabetes treated with insulin. Analysis of accuracy metrics included mean absolute relative difference (MARD), median absolute relative difference (ARD), and proportion of CGM values within 15, 20, and 30% or 15, 20, and 30 mg/dL of POC reference values for blood glucose >100 mg/dL or ≤100 mg/dL, respectively (% 15/15, % 20/20, % 30/30). Clinical reliability was assessed with Clarke error grid (CEG) analyses. RESULTS: A total of 218 patients were included (96% with type 2 diabetes) with a mean age of 60.6 ± 12 years. The overall MARD (n = 4,067 matched glucose pairs) was 12.8%, and median ARD was 10.1% (interquartile range 4.6, 17.6]. The proportions of readings meeting % 15/15, % 20/20, and % 30/30 criteria were 68.7, 81.7, and 93.8%, respectively. CEG analysis showed 98.7% of all values in zones A and B. MARD and median ARD were higher in the case of hypoglycemia (<70 mg/dL) and severe anemia (hemoglobin <7 g/dL). CONCLUSIONS: Our results indicate that CGM technology is a reliable tool for hospital use and may help improve glucose monitoring in non–critically ill hospitalized patients with diabetes.

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Data on the safety and efficacy of real-time CGM use in the hospital, particularly with implementation of remote monitoring (e.g., a glucose telemetry system), has grown.
“Data on the safety and efficacy of real-time CGM use in the hospital, particularly with implementation of remote monitoring (e.g., a glucose telemetry system), has grown (47,50-52).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [52]
There are limited studies on the efficacy or safety of SGLT2 inhibitors in hospitalized patients.
“There are limited studies assessing its efficacy or safety in hospitalized persons.1384”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1384]
The Study Design and Conclusions discuss inpatient Dexcom G6 continuous glucose monitoring, not SGLT2 inhibitors. A search for SGLT2 inhibitors and their efficacy or safety in hospitalized patients found no passage addressing the claim; the Conclusions’ reference to limited hospital experience concerns CGM instead. (LLM, conf=0.77)
Experimental — accuracy not yet measured
Preliminary studies show no adverse safety signals when SGLT2 inhibitors are started at discharge in stable patients.
“If persons are stable and ready for discharge, starting these agents at discharge and communicating with the patient’s primary clinician may represent a good opportunity to avoid clinical inertia, with preliminary studies showing no adverse safety signals.1384”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1384]
The Study Design and Conclusion describe an inpatient study of Dexcom G6 glucose-monitoring accuracy, not treatment initiated at discharge. Searches for SGLT2 inhibitors, discharge initiation, and adverse safety signals found no passage addressing the claim. (LLM, conf=0.77)
Experimental — accuracy not yet measured
Studies assessing effectiveness of inpatient CGM may ultimately lead to approved use of CGM for monitoring hospitalized individuals.
“Studies have been published assessing the effectiveness of this approach, which may ultimately lead to the approved use of CGM for monitoring hospitalized individuals (277,286-295).”
From 7. Diabetes Technology: Standards of Care in Diabetes—2025 (2025) · cites this paper as [290]

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Authors: Davis, G. M., Spanakis, E. K., Migdal, A. L., Singh, L. G., Albury, B., Urrutia, M. A., Zamudio-Coronado, K. W., Scott, W. H., Doerfler, R., Lizama, S., Satyarengga, M., Munir, K., Galindo, R. J., Vellanki, P., Cardona, S., Pasquel, F. J., Peng, L., & Umpierrez, G. E.
Affiliations: Emory University (US)
University of Maryland, Baltimore (US)
Baltimore VA Medical Center (US)
Corresponding author: Umpierrez, Guillermo E.
ORCID: Davis, Georgia M.
Spanakis, Elias K.
Migdal, Alexandra L.
Doerfler, Rebecca
Satyarengga, Medha
Munir, Kashif
Galindo, Rodolfo J.
Vellanki, Priyathama
Cardona, Saumeth
Pasquel, Francisco J.
Umpierrez, Guillermo E.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2021-07-01
Volume: 44
Issue: 7
Pages: 1641-1646
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc20-2856
PMC: PMC8323182
OpenAlex: W3168630898
Cited by: 160
References: 18
Citations by year: 2026: 23 · 2025: 35 · 2024: 38 · 2023: 41 · 2022: 19 · 2021: 4
FWCI: 19.04
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.diabetesjournals.org/content/license (vor)
Locations: Diabetes Care (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs (I01 CX001825)
National Institutes of Health (UL1TR002378)
National Institute of General Medical Sciences (K23GM128221)
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK113241, K23DK122199, K23DK123384, P30DK111024)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Keywords: Dexcom G6, continuous glucose monitoring, inpatient diabetes management, CGM accuracy, hypoglycemia, anemia, Clarke error grid, insulin-treated diabetes
MeSH terms: Aged, Blood Glucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Humans, Middle Aged, Retrospective Studies, Blood Glucose Self-Monitoring, Reproducibility of Results

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Accuracy of Dexcom G6 continuous glucose monitoring in non-critically ill hospitalized patients with diabetes

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