Accuracy of a Real-Time Continuous Glucose Monitor in Pediatric Diabetic Ketoacidosis Admissions.

Publication date: Mar 05, 2024

Objective Continuous glucose monitoring (CGM) devices are integral in the outpatient care of people with type 1 diabetes (T1D), though they lack inpatient labeling. FDA began allowing inpatient use during the COVID-19 pandemic, with some accuracy data now available, primarily from adult hospitals. Pediatric inpatient data remains limited, particularly during DKA admissions and for patients receiving IV insulin. Design and Methods This retrospective chart review compared point of care (POC) glucose values to personal Dexcom G6 sensor data during pediatric hospitalizations. Accuracy was assessed using mean absolute relative difference (MARD), Clarke Error Grids, and the percentage of values within 15/20/30% if glucose value >100mg/dL and 15/20/30mg/dL if glucose value ≤100mg/dL. Results Matched paired glucose values (N=612) from 36 patients (median age 14 years, 58. 3% non-Hispanic White, 47. 2% male) and 42 inpatient encounters were included in this sub-analysis of DKA admissions. The MARDs for DKA and non-DKA admissions (N=503) were 11. 8% and 11. 7%, with 97. 6% and 98. 6% of pairs falling within A and B zones of the Clarke Error Grid, respectively. Severe DKA admissions (pH < 7. 15 and/or bicarbonate < 5 mmol/L) had a MARD of 8. 9% compared to 14. 3% for non-severe DKA admissions. The MARD during administration of IV insulin (N=266) was 13. 4%. Conclusions CGM accuracy is similar between DKA and non-DKA admissions and is maintained in severe DKA and during IV insulin administration, suggesting potential usability in pediatric hospitalizations. Further study on the feasibility of implementation of CGM in the hospital is needed.

Concepts Keywords
100mg Admissions
Diabetes Care
Fda Cgm
Hispanic Continuous
Therapy Diabetes
Dka
Dl
Glucose
Inpatient
Insulin
Mard
Mg
Pediatric
Severe
Values

Semantics

Type Source Name
disease VO time
drug DRUGBANK Dextrose unspecified form
disease MESH Diabetic Ketoacidosis
disease MESH type 1 diabetes
disease VO LACK
disease MESH COVID-19 pandemic

Original Article

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