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The accuracy of the indirect method for determining the whole body phenylalanine kinetics was examined by employing a much larger study population than has previously been reported. Also, data were obtained from studies of patients with type I diabetes and nondiabetic control subjects to assess the effect of metabolic status. Findings indicated that the employment of approximation equations for phenylalanine kinetics can offer reasonable accurate rates of whole body protein synthesis. However, approximation of phenylalanine hydroxylation and Tyr flux is associated with unacceptably high and variable levels of error.

Objective: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia., Methods: Study patients were fitted with a remotely monitored CGM. CGM values were evaluated against glucometer readings. The CGM sensor calibration was performed if necessary. CGM values were used to dose insulin, without glucometer confirmation., Results: CGM accuracy against glucometer, expressed as mean absolute relative difference (MARD), was calculated using 812 paired glucometer-CGM values. The aggregate MARD was 10.4%. For time in range and grades 1 and 2 hyperglycemia, MARD was 11.4%, 9.4%, and 9.1%, respectively, with a small variation between medical floors and intensive care units. There was no MARD correlation with mean arterial blood pressure levels, oxygen saturation, daily hemoglobin levels, and glomerular filtration rates. CGM clinical reliability was high, with 99.7% of the CGM values falling within the "safe" zones of Clarke error grid. After CGM placement, the frequency of glucometer measurements decreased from 5 to 3 and then 2 per day, reducing nurse presence in patient rooms and limiting viral exposure., Conclusion: With twice daily, on-demand calibration, the inpatient CGM use was safe for insulin dosing, decreasing the frequency of glucometer fingersticks. For glucose levels >70 mg/dL, CGMs showed adequate accuracy, without interference from vital and laboratory values., Competing Interests: Disclosure A.D. holds shares in Dexcom, Sensionics, Tandem, and Insulet. M.P. holds shares in Dexcom and Insulet. A.M. holds shares in Medtronics. The other authors have no multiplicity of interest to disclose., (Copyright © 2022 AACE. Published by Elsevier Inc. All rights reserved.)

Background: Increasing use of glucose meters in hospitals has increased opportunities for infection transmission that have not been quantitatively assessed or managed., Methods: Before-and-after study of the effects of augmentation of glucose meter inventory and of assignment of glucose meters to individual patients on the sequential use of glucose meters on different patients in a 214-bed hospital., Results: During October 2008, 11,665 measurements were performed using 38 glucose meters on 803 patients. A total of 9,302 tests (79.7%) was performed sequentially within 24 hours on different patients. From October 28 through November 27, 2009, the glucose meter inventory on 3 high-use units glucose meters was increased (from 22 to 87) with meters assigned to individual patients; on 4 low-use units, glucose meter inventory was increased (from 16 to 28) without assignment to individual patients. Sequential glucose meter use on different patients within 24 hours decreased by 95.1% on high-use units and increased by 17% on low-use units., Conclusion: Use of glucose meters was associated with a high number of opportunities to transmit infections, and those opportunities were reduced only when glucose meters were assigned to individual patients. Recent guidance from the Centers for Disease Control and Prevention and the US Food and Drug Administration to assign glucose meters to individual persons whenever possible is relevant to inpatient care., (Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)