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Accuracy of a Real-Time Continuous Glucose Monitor in Pediatric Diabetic Ketoacidosis Admissions.
- Source :
-
Diabetes technology & therapeutics [Diabetes Technol Ther] 2024 Sep; Vol. 26 (9), pp. 626-632. Date of Electronic Publication: 2024 Mar 20. - Publication Year :
- 2024
-
Abstract
- Objective: Continuous glucose monitoring (CGM) devices are integral in the outpatient care of people with type 1 diabetes, although they lack inpatient labeling. Food and Drug Administration began allowing inpatient use during the coronavirus disease 2019 (COVID-19) pandemic, with some accuracy data now available, primarily from adult hospitals. Pediatric inpatient data remain limited, particularly during diabetic ketoacidosis (DKA) admissions and for patients receiving intravenous (IV) insulin. Design and Methods: This retrospective chart review compared point-of-care 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 >100 mg/dL and 15/20/30 mg/dL if glucose value ≤100 mg/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 subanalysis 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 nonsevere 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.
- Subjects :
- Humans
Adolescent
Male
Female
Retrospective Studies
Child
Hospitalization statistics & numerical data
Hypoglycemic Agents therapeutic use
Hypoglycemic Agents administration & dosage
Diabetic Ketoacidosis blood
Blood Glucose analysis
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 1 blood
Diabetes Mellitus, Type 1 complications
Insulin administration & dosage
Insulin therapeutic use
COVID-19 blood
COVID-19 complications
Subjects
Details
- Language :
- English
- ISSN :
- 1557-8593
- Volume :
- 26
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Diabetes technology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 38441904
- Full Text :
- https://doi.org/10.1089/dia.2023.0542